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At least 1,225 records · Page 68Linked to original sources
PubMed1987

Quantitation of urinary metabolites of toluene, xylene, styrene, ethylbenzene, benzene and phenol by automated high performance liquid chromatography.

An automated high performance liquid chromatographic method (HPLC) for the direct determination of urinary concentrations of hippuric acid (HA), and o-, m- and p-methyl hippuric acids (MHAs), metabolites of toluene and o-, m-, and p-xylenes, and of urinary phenyl glyoxylic acid (PGA) and mandelic acid (MA), metabolites of styrene or ethylbenzene, is described. Methanol was added to urine, the mixture was centrifuged and the supernatant was injected into HPLC. A stainless-steel column packed with octadecyl silanized silicate was used and the mobile phase was a mixed solution of 5 mM potassium phosphate monobasic/acetonitrile (90/10). The method is simple and specific. Urine can be analyzed without solvent extraction. Analysis can be performed satisfactorily within 45 min for samples containing HA, MHAs, PGA and MA, and within 15 min for those containing HA, PGA and MA. Another automated HPLC method for the determination of urinary concentrations of phenylsulfate (PhS) and phenylglucuronide (PhG), metabolites of benzene and phenol, is also described. Urine was centrifuged and the supernatant was injected into HPLC. A column packed with octadecyl silicate and a mobile phase of 50 mM of potassium phosphate monobasic/acetonitrile (85/15) were used. The whole analyses and quantitative determination can be performed within 15 min for samples containing PhS and PhG in the worker's urine with a simple mobile phase. The accuracy and precision in the present methods by the use of automated HPLC were satisfactory.

Autoanalysis↗
PubMed1982

Automated image analysis of glioblastomas and other gliomas.

Tumours of the neuroglia, 172 in all (50 glioblastomas, 65 fibrillar and gemistocytic astrocytomas, 26 pilocytic astrocytomas and 31 oligodendrogliomas), were studied by automated microscopic picture analysis. Thirteen morphometric and densitometric parameters of the tumour cell nuclei as well as two mitotic parameters were determined on 4 micrometers thick Feulgen slide preparations. The correlation of the results with subjectively established grade of malignancy was examined. A close correlation was found between almost all morphometric-densitometric nuclear parameters and the morphologically established behaviour of the tumours under study. Based on these results both the method of automated microscopic picture analysis and the selected parameters have been assessed as efficient for the evaluation of the behaviour of glial tumours. The results are readily reproducible and can be obtained without requiring much time. An other advantage of this method is the use of histological preparations, which allows a comparison of the overall structure of the tumour as well as a pinpointed examination of those regions that are representative of the tumour. Subjective grading of glial tumours has been greatly objective by automation.

Adolescent↗
PubMed1986

Prescription: office automation.

The mission statement of Minneapolis Children's Medical Center reads, in part, "Mindful of the unique characteristics of children, MCMC's missions is to provide a team of health care professionals attuned to the special needs of the total child, at all ages from prenatal through adolescent, in a uniquely designed facility." Therefore an "open" professional staff, rather than a medical staff, was established consisting of physicians, dentists, and other health professionals with advanced degrees at the master's level or above, including, but not limited to, psychologists, social workers, clinical nurse specialists, chaplains, audiologists, and speech pathologists. This professional staff has grown to 650 members, extremely large for a 122-bed hospital. The professional staff office needed help in managing the volume of information associated with this large staff. To meet that need, in addition to the needs of other hospital areas, MCMC's administration made the decision to purchase office automation equipment and established a committee of hospital-wide users, rather than managerial staff, to survey their own needs, select vendors, and make the final recommendation. The word-processing system selected now maintains 650 physician profiles, each with 44 variables. Whereas prior to automation 25 separate lists needed to be updated each time a professional staff member was either added or deleted, now only individual physician profiles need to be adjusted. Programs were then designed to automate the many reports that must be done. In this paper we propose to describe this selection process and relate how the system developed has streamlined and simplified the work of the professional staff office to enable it to increase its output by over 300% without adding staff.

Electronic Data Processing↗
PubMed1983

The effect on cost of medical care for patients treated with an automated clinical audit system.

An automated clinical medical record and audit system was developed to evaluate the effect of modifying physician behavior at the control points in the ambulatory care process and to determine if this change was reflected in patient care cost outcomes. This study compared clinical and cost results of patients in an experimental group, who had the automated record and audit system, to a control group, who had a traditional clinic record without chart audit. Physicians responded to the automated audit suggestions at a rate of 50.25 in the experimental group and 37.3 in the control group. No major differences were observed in clinical outcomes, with the exception of the number of days of hospitalizations and, consequently, the cost of hospitalizations. The experimental group cost for hospitalizations was one-third of the control group and accounted for a majority of the differences in the total annual cost for the two groups.

Ambulatory Care↗
PubMed1992

A computer-based, automated, telephonic system to monitor patient progress in the home setting.

In this report we describe an automated, telephonic system to monitor the progress of patients convalescing at home. The system includes a computerized central station that is capable of automated voice communication over the telephone, using voice reproduction, and touch-tone recognition. Peripheral hardware in multiple monitored homes need include only a touch-tone telephone, but may also be augmented by inexpensive, rudimentary diagnostic aids, such as a scale for body weight, a thermometer, or a blood pressure cuff and manometer. Current central hardware includes a NeXT computer, a fax modem, and a specialized telecommunications modem developed specifically for voice telecommunication using the NeXT. The central station acts like a robotic nurse in that it asks patients a series of questions and records the responses. The subjective questions to be asked are patient individualized and pre-selected by the physician from a question menu including items targeted specifically for the patient's disease or condition. In addition, clinical data such as body weight, blood pressure, and body temperature obtained from in-home diagnostic aids may be transmitted to the central station over the telephone using touch tones. The time-of-day and frequency of calling are pre-selectable, according to the patient's preference and clinical status. Data obtained by the central station can be easily accessed by the duty nurse via menu driven software. Reports depicting significant responses as a function of time are generated in graphical format to facilitate rapid identification of adverse trends. Hard copy reports can be dispersed directly by fax. Results from a pilot study show patients with cardiac disease readily use the system without difficulty or complaints. In one patient a five pound increase in body weight was detected, which prompted the patient's cardiologist to adjust his medication. In this way automated telephone follow-up can provide early detection of complications before they become severe, making the home environment safer and more secure for convalescence and contributing to reduced health-care costs.

Computer Systems↗
PubMed1992

Eight year's experience with automated anesthesia record keeping: lessons learned--new directions taken.

For the past eight years, an automated anesthesia record keeping system, COMANDAS (COMputerized ANesthesia Data Acquisition System) has been used in the cardiovascular operating rooms at Mayo Clinic. The automated anesthesia record is designed to match the traditional hand-written record and becomes part of the official medical record. COMANDAS is interfaced with the physiologic monitor and mass spectrometer in each OR, and a number of other computers within the Mayo Medical Center. Since the introduction of COMANDAS over 24,000 surgical procedures have been charted. The anesthesia record is more complete, consistent in organization, and legible when compared to a hand-written record. Recently, it was determined that the computers and peripherals that make up COMANDAS were wearing out and that the vendors would no longer support or replace the equipment. A process to find a replacement for COMANDAS was then begun. Although the cardiovascular anesthesia group was satisfied with the automated anesthesia record, there were a number of areas in which improvement was desired. A systematic evaluation of the system was begun with a survey of the users. The majority of those surveyed felt that COMANDAS was a useful system which made parts of their job easier. The user interface, method of manual data entry, time to produce the record and difficulty learning the system were the source of the greatest dissatisfaction. Artifacts, networking, interfacing with other devices and computers were also issues for the replacement system. Most commercial systems were found wanting in one or more areas of significance. The most practical solution appeared to be the modification of a currently available intensive care unit patient data management system.

Anesthesiology↗
PubMed1995

Spurious ST segment depression by automated ST segment analysis.

Perioperative myocardial ischemia has been shown to be predictive of adverse cardiac outcome [1]. One method of detecting intraoperative myocardial ischemia is automated ST segment monitoring [2]. The rationale behind automated ST monitoring is that the clinician will be promptly alerted to ischemic changes in the ECG. This may lead to earlier intervention and, perhaps, improved outcome [3]. We describe a case in which automated ST segment monitoring falsely signaled the presence of intraoperative ST segment depression. This event emphasizes the importance of confirming the validity of ST segment changes before instituting therapy.

Aged↗
PubMed1996

Automated determination of left ventricular volume curves from bi-plane digital angiography without explicit use of edge detection algorithms.

Automated computation of left ventricular (LV) global and regional function using contrast angiography has not yet become a routine procedure with the advent of digital cardiac imaging systems. We describe a new technique to compute LV volume curves which does not require the use of manual or semi-automated detection of endocardial borders and provides on-line implementation of volumetric curves and computation of pressure volume loops during catheterization. The approach uses the concepts of variable entropy (or information) of left ventricular images throughout the cardiac cycle. LV volume curves are computed with an interpolation scheme using those LV volume curves of a patient data base which are associated with the closest variation in entropy in the RAO projection to the analyzed patient data according to a simple metric. Computed LV volume curves were correlated with those obtained with manual tracing. Left ventricular ejection fraction (LVEF), time to end systole (TES) and angiographic cardiac output (CO) were compared to those obtained with the manual method. Results using a data base of 365 patients revealed excellent correlation (r = 0.97) between manually derived volume curves and volume curves computed with the automated technique within a large range of LVEFs. In 87% of all cases the computed LVEF values were found within +/- 10% of the value obtained with the gold standard method. The systolic phase of the volume curves showed that 81% of all cases had the same accuracy. The TES showed much more variation due to undersampling of the cardiac cycle in time (r = 0.71).

Algorithms↗
PubMed1990

A new approach for the automated definition of path lines in digitized coronary angiograms.

For the quantitative analysis of a coronary segment from a coronary (cine)angiogram, an initial path line is required which functions as a model for the subsequent automated contour detection. For on-line applications, a new method for the automated definition of arterial path lines has been developed. Required user-interaction consists of the manual definition of a beginning and an endpoint of the arterial segment to be analyzed. The method is based on a combination of a beam tracer and a box technique. A validation study was performed on 47 non obstructed arteries of various lengths and diameters, and on 56 arterial segments with obstructions (up to 86 percent diameter stenosis). In 89% of the cases an acceptable path line was found after the first iteration; the success score increased to 99%, if a simple manual correction was allowed (2 iterations). The method is extremely fast: the overall average search time for the first iteration was 266 ms, for the second iteration 211 ms. Therefore, it may be concluded that this new technique for the automated definition of arterial path lines is extremely suitable for on-line applications.

Algorithms↗
PubMed1996

Evaluation of an automated auditory brainstem response infant hearing screening method in at risk neonates.

UNLABELLED: An automated auditory brainstem response (ABR) method-the ALGO-1 Plus- has been developed for hearing screening in healthy neonates. The aim of this study was to test the validity of this automated ABR screening method in at-risk neonates in a neonatal intensive care unit. Two hundred and fifty at-risk neonates were selected for screening according to the criteria of the American Joint Commerce on Infant Hearing. All 250 neonates were screened with the ALGO-1 Plus for bilateral hearing loss. When two consecutive screenings pointed to bilateral hearing loss ("refer") further audiological investigations were performed and where necessary therapeutic measures were taken. All children who "passed" the screening unilateral or bilateral enrolled in a nationwide behavioural screening programme at the age of 9 months as well as in a 6-monthly follow up programme documenting speech and language development. A total of 245 (98%) neonates passed the ALGO-1 screening, 230 (92%) at the first attempt and 15 (6%) at the second attempt. Five (2%) were referred with bilateral hearing loss. One of these died of congenital rubella shortly after screening and bilateral congenital hearing loss of > 35 dB was confirmed in the other 4. None of the infants who passed the screening were discovered to have moderate to severe bilateral hearing loss (> 40 dB) with behavioural screening (n = 183/233) or at follow up (n = 233/233). In this study, all at-risk neonates with bilateral congenital hearing loss were detected with ALGO-1 Plus screening. No false-negatives were discovered. CONCLUSION: The ALGO-1 Plus infant hearing screener can be used as a valid automated ABR-screener to detect hearing loss in at-risk neonates in a neonatal intensive care setting.

Evoked Potentials, Auditory, Brain Stem↗
PubMed1987

Automated bacteriuria screening using the Berthold LB 950 luminescence analyser.

The Berthold LB950 Automatic Luminescence Analyser was used to estimate bacterial adenosine triphosphate in urine. The system provided a rapid (15 min) and fully automated screening test for bacteriuria at the 10(5) CFU/ml level. Bioluminescence results for 1040 urines were compared with viable counts using two reference culture methods and frequency distributions of bacterial counts and adenosine triphosphate levels were calculated. With a specificity of 79% the automated method showed a sensitivity of 84% using a pour plate reference count and 91% using a standard loop reference count. When contaminated urines were excluded the sensitivity improved to 98%. The automated bioluminescence test, though expensive, was shown to work well with good quality specimens.

Adenosine Triphosphate↗
PubMed1984

An automated medical record system, 10 years later.

An automated medical record system (AMRS) at the Harvard Community Health Plan supports medical records membership and the management needs of the 146,000-member health maintenance organization. The ARMS is fully integrated into the operation of HCHP's health centers and into the clinical practice of the medical staff. User interviews conducted as part of a systems planning effort revealed a high level of satisfaction with the system. The acceptance of and enthusiasm for the AMRS was coupled with a variety of ideas for improvement and enhancements to the system. Most of these suggestions were not uniquely related to the automated technology supporting the system but rather addressed medical records issues familiar to conventional paper systems. While this distinction is subtle, it further confirms the viability of an automated system and suggests directions for future growth.

Boston↗
PubMed2002

Progress towards automated diabetic ocular screening: a review of image analysis and intelligent systems for diabetic retinopathy.

Patients with diabetes require annual screening for effective timing of sight-saving treatment. However, the lack of screening and the shortage of ophthalmologists limit the ocular health care available. This is stimulating research into automated analysis of the reflectance images of the ocular fundus. Publications applicable to the automated screening of diabetic retinopathy are summarised. The review has been structured to mimic some of the processes that an ophthalmologist performs when examining the retina. Thus image processing tasks, such as vessel and lesion location, are reviewed before any intelligent or automated systems. Most research has been undertaken in identification of the retinal vasculature and analysis of early pathological changes. Progress has been made in the identification of the retinal vasculature and the more common pathological features, such as small aneurysms and exudates. Ancillary research into image preprocessing has also been identified. In summary, the advent of digital data sets has made image analysis more accessible, although questions regarding the assessment of individual algorithms and whole systems are only just being addressed.

Diabetic Retinopathy↗
PubMed1988

A microcomputer based automated, quantitative coronary angiographic analysis system.

Rapid and accurate assessment of coronary artery stenotic severity is important in therapy and understanding of coronary artery disease. Since automated systems minimize prejudice and variations in analysis, we developed an automated, quantitative coronary analysis system utilizing an IBM PC-XT computer. Film images (35 mm) were cine-to-video converted and subsequently digitized by an IBM PC-XT computer. Given an approximate center line, the computer automatically detected edges, corrected for X-ray magnification, and calculated arterial dimensions. On objects of known dimensional sizes, the correlation coefficient between actual and calculated dimensions was 0.996 (p less than 0.01) with a standard error of estimate of 0.07 mm and +/- 3.0% reproducibility. For objects less than 1 mm in diameter, the standard error of estimate was 0.05 mm with +/- 4.1% reproducibility. However, with minimal contrast material (25%), the standard error of estimate increased to 0.20 mm with +/- 7.2% reproducibility. The results indicate that automated, quantitative coronary angiography can be achieved using an inexpensive IBM PC-XT based system, provided that the vessels are adequately opacified.

Adult↗
PubMed1985

Clinical comparison of automated auscultatory and oscillometric and catheter-transducer measurements of arterial pressure.

Arterial pressure measurements recorded from a radial artery catheter-transducer (RAC) system were compared with similar data obtained from an automated sphygmomanometer that uses both oscillometric (OSC) and auscultatory measurement techniques. Data were obtained from 50 patients during and immediately after surgery. The fundamental frequency of the RAC system was 23.7 +/- 6.7 Hz (mean +/- SD; range, 13 to 40 Hz), and the damping coefficient was 0.26 +/- 0.06 (mean +/- SD; range, 0.15 to 0.34). Linear regression analysis of RAC against OSC values (n = 385) revealed the following correlations: (1) systolic pressure: OSC = 0.92(RAC) + 3.5, r = 0.91; (2) diastolic pressure: OSC = 0.92(RAC) + 1.3, r = 0.76; and (3) mean pressure: OSC = 0.96(RAC) + 0.68, r = 0.84. There were significant differences between each pair of pressure values; mean percent differences (RAC pressure minus OSC pressure) were 4.5 +/- 0.3%, 5.5 +/- 0.7%, and - 2.7 +/- 0.5% for systolic, diastolic, and mean values, respectively. Manual and automated auscultatory measurements closely agreed, and both correlated well with OSC values for systolic and diastolic pressure. However, both manual and automated auscultatory, as well as OSC measurements, underestimated RAC systolic and overestimated RAC diastolic pressure.

Adolescent↗
PubMed1987

The clinical use of the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System. A preliminary report.

While performing his complex array of tasks, the anesthesiologist is also responsible for maintaining an anesthetic record. Up to now, this has been done by hand. The clinical use of automated anesthesia record keeping is presently evaluated. The anesthesia records generated by the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System is compared to hand written records. The differences between the two records of identical patients are quantified as erroneous or missing data. With the criteria adapted, we found significant and clinically relevant differences which stress the importance of automated record keeping.

Anesthesiology↗
PubMed1998

A case for automated tape in clinical imaging.

Electronic archiving of radiology images over many years will require many terabytes of storage with a need for rapid retrieval of these images. As more large PACS installations are installed and implemented, a data crisis occurs. The ability to store this large amount of data using the traditional method of optical jukeboxes or online disk alone becomes an unworkable solution. The amount of floor space number of optical jukeboxes, and off-line shelf storage required to store the images becomes unmanageable. With the recent advances in tape and tape drives, the use of tape for long term storage of PACS data has become the preferred alternative. A PACS system consisting of a centrally managed system of RAID disk, software and at the heart of the system, tape, presents a solution that for the first time solves the problems of multi-modality high end PACS, non-DICOM image, electronic medical record and ADT data storage. This paper will examine the installation of the University of Utah, Department of Radiology PACS system and the integration of automated tape archive. The tape archive is also capable of storing data other than traditional PACS data. The implementation of an automated data archive to serve the many other needs of a large hospital will also be discussed. This will include the integration of a filmless cardiology department and the backup/archival needs of a traditional MIS department. The need for high bandwidth to tape with a large RAID cache will be examined and how with an interface to a RIS pre-fetch engine, tape can be a superior solution to optical platters or other archival solutions. The data management software will be discussed in detail. The performance and cost of RAID disk cache and automated tape compared to a solution that includes optical will be examined.

Costs and Cost Analysis↗
PubMed2001

Automated examination notification of emergency department images in a picture archiving and communication system.

This study compares the timeliness of radiology interpretation of Emergency Department (ED) imaging examinations in a picture archiving and communication system (PACS) before and after implementation of an automated paging system for notification of image availability. An alphanumeric pager for each radiology subspecialty (chest, pediatrics, bone, neuroradiology, and body) was used to alert the responsible radiologist that an ED imaging examination is available to be viewed on the PACS. The paging system was programmed to trigger off of the PACS database when an image is received on the appropriate radiology display station. The pager message includes the radiology accession number and examination description (such as chest, two-view, or c-spine, etc). The PACS paging tool performance was assessed by calculating the time elapsed, for each ED imaging examination, from the Time Imaged to the Time of Interpretation, where the Time Imaged is the actual image completion time measured at the imaging modality, and the Time Interpreted is the time a radiology interpretation is rendered to the ED, and is measured from the Radiology-to-ED fax time stamp. These measures were analyzed pre- and post-paging system implementation to determine any impact of the automated notification tool on radiology service turnaround time. Results show an improved radiology response time from image completion to interpretation rendered to ED clinicians, down from hour(s) to minutes, with the automated paging examination notification system. Examinations are read by the appropriate radiology specialty section in a more timely fashion, and fewer cases go unread by radiology.

Emergency Service, Hospital↗