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At least 1,315 records · Page 73Linked to original sources
PubMed1990

Recording vectorcardiographic loops with a microdot thermal printer.

The principle of recording vectorcardiographic loops with a microdot thermal printer is developed using a very small memory area. It is based on two previous achievements: (i) orthogonal electocardiogram derivation from the conventional 12-lead system and (ii) recoding of biomedical signals with a microdot thermal printer, thus permitting the VCG to be just an extension of the standard ECG. The principle consists of decomposing the loop into horizontal sectors each one representing a non-ambigous function. It is implemented in ECG instruments, using the Gotemba microdot thermal printers TLP 480Z and TLP 880Z produced in Japan.

Computer Peripherals↗
PubMedDate not supplied

The computer as a tool in the diagnosis and treatment of peripheral vascular disease.

The application of a mini computer to a routine diagnostic vascular laboratory has been assessed in over 4,500 patients over a period of 5 years. The laboratory functions to provide diagnosis of peripheral vascular disease. The computer functions are: scientific, in which it is used for modelling the arterial system and for applying diagnostic algorithms using haemodynamic signals re-input data, data base management, in which it is used to store clinical histories, the results of haemodynamic tests, and data for reconstructive surgery, and administrative, in which it is used for laboratory booking, report generation and management and workload statistics.

Blood Flow Velocity↗
PubMed1995

[Prevention of postmenopausal osteoporosis: how effective is transdermal hormone substitution? (Continuous estradiol plus sequential oral norethisterone acetate)].

QUESTION: Can osteoporosis and cardiovascular risk be effectively and simultaneously prevented with transdermal estradiol replacement therapy (in combination with norethisterone acetate 1 mg per day, oral, cyclically for 12 days monthly)? METHODS: A selected, representative group of healthy women with an average age of 52 years, with confirmed natural menopause for 1 to 4 years, randomly allocated to a treatment-group with hormone replacement (n = 42) and a control-group (n = 70), with homogeneous main parameters in the two groups, can be compared, without distortion of the findings, during the period of the two-year intervention study: the purely trabecular bone mass in the distal radius was specifically measured, prospectively, with the highly accurate, three-dimensional, peripheral quantitative computed tomography (thin-und multi-layer technology; Densiscan 1000) and the serum lipid, lipoprotein and apolipoprotein levels were measured (at the end of the gestagen cycle) in the morning fasting state. RESULTS: One-third of the persons of the control-group showed an annual loss of trabecular bone mass of more than 3.5%. These fast-losers, who on the basis of the annual bone-destruction rates are to be classified in the upper tertiles of the two groups, suffered a loss of trabecular bone of 4.2 +/- 0.4% (mean +/- SEM) in the treatment-group, compared with 7.3 +/- 1.0% in the control-group in the first year; in the second year no loss of trabecular bone was observed in the treatment-group, while in the control-group the high rate of trabecular-bone destruction continued unchanged. The slow-losers (belonging to the middle and lower tertiles according to the bone loss rates) showed equally little change in their trabecular bone mass after the menopause, which can be described as physiological, with mean yearly values between -1.1 and +0.4%, both in the treatment-group and in the control-group. Under the transdermal hormone replacement therapy only the triglyceride and total cholesterol levels fell in comparison with the control-group, but without any significant changes in the atherogenic index, either in regard to the LDL/HDL or apolipoproteins B/A-I ratios. CONCLUSIONS: To be able to make valid statements it is necessary to study the effectiveness of a measure or of a preparation for the prevention of osteoporosis in fast-losers, who are to be randomized to the respective study-groups and whose status has been confirmed by tests. Transdermal hormone replacement therapy--low estradiol dose in combination with NETA--stops the pathologically increased loss of trabecular bone only in the second year of the treatment; the antiatherogenic effect, however, is not confirmed. Only an individually adjusted therapy based on test results, with follow-up controls, can constitute an efficient, ethically justifiable postmenopausal prophylaxis of both osteoporosis and coronary heart disease.

Administration, Cutaneous↗
PubMed1995

Communication in health care.

For routine communication, care providers still mainly rely on paper documents and paper mail. Evidence exists, however, that this communication can be improved, both by a better content of information exchange and by a more timely deliverance of this information. At present, several alternatives to paper-based communication are available, such as the Fax, the Smart Card, electronic mail, and electronic data interchange. This paper describes existing communication problems, and examines the current state of development and research aimed at improving this communication using electronic communication techniques that are gradually replacing paper-based communication. Applicability and shortcomings of these new techniques are also discussed.

Computer Communication Networks↗
PubMed1995

[Osteoporosis prevention initiated with peripheral quantitative computerized tomography. Thin-layer and multi-layer technique].

In a representative, randomized control group of 70 healthy confirmed postmenopausal women (natural menopause for one to four years) with an average age of 52 years, it was possible to carry out a prospective study over a period of two years, during which the bone mass was investigated regularly by means of peripheral quantitative computed tomography (pQCT, Densiscan type, thin- and multi-layer technology). The distal, purely trabecular and purely compact bone mass of the radius and tibia are measured separately. The epiphyseal trabecular bone masses of the radius and tibia (262 +/- 8 mg/cm3 and 252 +/- 8 mg/cm3, respectively) are initially homogeneous, but over time they show different rates of yearly loss of bone mass: 3.0 +/- 0.4%, compared with 1.5 +/- 0.3% (means +/- SEM). Based on the bimodal frequency distribution of the annual loss rates in the core trabecular volume of the distal radius, fast losers lose more than 3.5% per year, with no significant difference between the first and the second year of observation. Women in the quintile with the highest trabecular bone mass (328 to 458 mg/cm3 at baseline) are slow losers. These women show an absolute loss of 3 mg/cm3 per year, while the women in the lowest quintile (102 to 210 mg/cm3 at baseline), with a proportion of 64% fast losers, lose an average of 10 mg/cm3, irrespective of age, number of fertile years, age at menopause and body-mass index. The bone masses in the metaphyseal compact bone remain constant.2+ a screening program before architectural changes in trabecular bone reach a critical point (i.e. in the reversible stage of osteoporosis), these women can be reliably identified within six months and monitored effectively and economically. With the general risk factors of postmenopausal osteoporosis an individual's risk of rapid bone loss cannot be predicted or determined; therefore, the precise measurement of purely trabecular bone is indispensable.

Aged↗
PubMed1994

[Bone density in anorexia nervosa--with comments on prevention and therapy of osteoporosis].

Anorectic women often have reduced bone density, which may predispose them to osteoporosis and fractures. The mechanisms involved and their relative contribution are still a matter of discussion. Most studies have been done in young adults, but during the past few years children and adolescents have also been investigated. In this paper we present preliminary data on bone mineral parameters in young anorectic females during the first few months of inpatient treatment. Measurement of trabecular bone density (TBD), bone mineral density (BMD) and body composition were done by peripheral quantitative computed tomography (pQCT) at the distal end of the radius and by dual-energy X-ray absorptiometry (DEXA) in ap-projection. Hormonal parameters and clinical course were monitored. Baseline values of TBD and BMD seemed to be generally within the normal range. Follow-up measurements showed a significant reduction in TBD but not in BMD in most patients during the first two months of treatment despite clinical improvement. There was no clear correlation with hormonal or clinical parameters. Further evaluations are necessary. Possible therapeutic consequences are discussed.

Adolescent↗
PubMed1994

[The personal computer as a rehabilitation aid for severely handicapped patients].

The case example presented outlines the efforts of a quadriplegic young man who has succeeded in finding himself an occupational basis through training as an expert in electronic desktop publishing (DTP). Due to his severe mobility handicaps, computerized workstations for DTP training had been put up both in the training company and in his own home. These Desktop Publishing systems enable even very severely disabled persons to perform at a par with non-disabled persons. If this adapted workplace is connected to a communication network, the work results need not be delivered materially to the place where they are needed or further worked on, but can be dispatched electronically to the addressee. Communication networks enable the disabled person to easily exchange data with other workstations, or, through the use of modems to access the public telephone system, to send messages from his private environment (e.g., for sending fax messages or placing information in his partners' electronic mailboxes).

Adult↗
PubMedDate not supplied

Dr. Welford's chart notes.

We examined a robust and highly customizable menu-based charting program created and maintained by a practicing physician. The program offers a number of well-conceived and often elegantly executed features, integrating clinically related administrative and decision-support functions at a reasonable price. The drawbacks are lack of a graphic interface with mouse support, limited importing and exporting abilities, and dependence on a single individual for maintenance of the program.

Computer Peripherals↗
PubMed1995

[Computer-assisted speech recognition in diagnostic pathology. Development of the DragonDictate-30 K system for documentation].

The speech recognition system DragonDictate-30 K is the first commercially available product for personal computers (PC) that includes a thesaurus of 30,000 words which can replace the computer keyboard completely for report writing. The system is speaker-adaptative, i.e., it can learn the phonetic pattern of the pathologist's voice. We have developed a thesaurus with special terms from the field of diagnostic pathology to shorten the time-consuming training phase. DragonDictate is compatible with all text-oriented DOS computer software tools. The recommended minimal hardware configuration is a personal computer with a 80,486 processor with 16 MB on board and a 200 MB hard disk.

Computer Peripherals↗
PubMed1996

[Acute cerebellar syndrome after treatment with 5-fluorouracil].

We report on a case of 5-fluorouracil induced neurotoxicity during 5-fluorouracil cisplatin combination chemotherapy for advanced head and neck squamous cell carcinoma. The initial manifestations included an acute cerebellar syndrome and peripheral neuropathy. Computed tomography of the brain was normal. The results of nerve-conduction studies were compatible with the diagnosis of distal sensory neuropathy. The patient experienced improvement, without treatment, four weeks after cessation of chemotherapy. The role of cisplatin and alcohol abuse in this neurotoxic episode, can not yet completely be excluded.

Alcoholism↗
PubMed1997

Altered bone metabolism in inflammatory bowel disease.

UNLABELLED: A reduced bone mineral density has been reported in inflammatory bowel disease (IBD). OBJECTIVE: To assess the mechanisms of bone disease in IBD. METHODS: We studied in 90 patients (61 with Crohn's disease, 22 with ulcerative colitis, 7 with indeterminate colitis) biochemical markers of bone metabolism in serum and bone mineral density by peripheral quantitative computed tomography at the forearm. RESULTS: Forty-five percent of the patients had a reduced bone density (Z score < -1). Serum calcium was normal in most patients, vitamin D deficiency was documented in 17%. Osteocalcin, a serum marker of bone formation, was decreased in 26% (1.2 +/- 0.1 ng/ml), whereas the carboxyterminal cross-linked telopeptide of type I collagen (ICTP), a recently described serum parameter of bone breakdown, was stimulated in 38% (10.4 +/- 2.3 microg/L). Of 33 patients with increased ICTP levels, 19 showed a decreased bone density (Z score < -1), and 2 of them never received steroids. An active status of the underlying disease in most patients with increased ICTP levels suggests a direct effect of the underlying IBD. In the whole series of patients with a history of active disease (n = 34), 47% had signs of an increased bone degradation (ICTP > 5 microg/L; mean, 12.9 +/- 4.7 microg/L). Data derived from a retrospective survey of 245 patients with IBD suggest that the prevalence of bone fractures in IBD is unexpectedly high, particularly in patients with a long duration of disease, frequent active phases, and high cumulative doses of corticosteroid intake. CONCLUSIONS: Several mechanisms may be involved in IBD-associated bone disease: (1) a high inflammatory activity directly induces bone degradation via yet unknown pathways, (2) treatment with corticosteroids may exert catabolic effects on the bone, or (3) malabsorption and vitamin D deficiency may activate bone turnover.

Adolescent↗
PubMed1997

Wrist dermatitis: contact allergy to neoprene in a keyboard wrist rest.

A case of allergic contact dermatitis to a keyboard wrist rest containing neoprene is reported. The patient, who had a history of sensitivity to rubber products, developed an acute vesicular reaction of the palmar aspects of her distal wrists, followed by eczematous patches of her extremities and face. Treatment with prednisone, a 3-week tapering dose (60, 40, 20 mg), cleared the dermatitis. The widespread uses of neoprene are discussed and suggest that neoprene will become a common source of contact dermatitis as the potential sources of exposure increase.

Adult↗
PubMed1997

[Effects of bisphosphonates on the mechanical efficiency of normal and osteopenic bones].

Bone mechanical competence (stiffness, strength) at organ level is determined by mechanical quality (intrinsic stiffness) and spatial distribution (macro-architecture) of bone material in cortical tissue (in every bone) and trabecular network (in vertebral bodies). These properties are inter-related and controlled according to mechanical usage by a feed-back mechanism known as mechanostat. Therefore, the effects on bone fragility of any treatment should be evaluated concerning the way they may have affected bone material or geometric properties as well as the mechanostatical interactions between them. Standard densitometry does not provide the necessary data, but some alternative methodologies (as peripheral quantitative computed tomography, pQCT) are being developed to complement or even substitute SPA, DPA or DXA determinations. Bisphosphonate (BP) effects on bone biomechanics have been studied only in animal models. Many sources of variation of results (type of compound, dose, mode of administration, species, race, sex, age, age since menopause, type of bone, remodeling ability of the skeleton, endocrine-metabolic status, interactions with other treatments, etc.) have been reported. In general terms, BPs are beneficial concerning cortical bone strength in purely modeling species (rodents) and trabecular strength in remodeling mammals (dogs, baboons). This positive action at organ level depends on independent improvements in bone macro-architecture (mainly affected by bone modeling) and material stiffness (chiefly affected by bone composition and remodeling). On one hand, bone macro-architecture has been positively affected by BPs in normal (not in ovariectomy (OX), steroid- or disuse-induced osteopenic) animals. On the other, bone material quality has been improved in the latter but not in the former. Mechanostatic interrelationships have been differently affected according to the compound employed. Results reported by ours and other laboratories concerning the three derivatives available nowadays in Argentina were reviewed and summarized. Pamidronate improved small rodents' cortical bone strength and geometric properties at low doses but impaired mineralization, material properties and strength at toxic doses. In normal, remodeling animals it improved mechanical properties in vertebral bodies but not in long bones. It also prevented the negative impact of OX-, steroid- or disuse-induced osteopenia in rats by improving bone material properties without affecting normal mechanostatic interrelationships. Olpadronate exerted positive effects on long-bone strength at any dose in normal rats and mice by improving cross-sectional properties and preserving both mineralization and material properties. These effects were highly dependent upon bone deformability, body weight, and mechanical usage of the limb as an evidence of an anabolic interaction induced on bone modeling and mechanostatic interrelationships. This compound also prevented the OX- or disuse-induced impairment in rat cortical long-bone strength and recovered rat cortical bone when given since 3 months after OX by improving only bone material quality. No interaction with bone mechanostat was detected in these studies. Alendronate effects on bone biomechanics in normal rats and dogs were positive only in long treatments. They were highly dependent on body weight of the animals, hence a positive interaction with bone mechanostat should be hypothesized. It also prevented the negative impact of OX in rat femurs by improving cortical material quality with no effect on cross-sectional properties, i.e., exerting an anti-catabolic interaction with bone mechanostat. The effects of all the three compounds were found positive for bone health, yet their mechanisms of action varied with type of bone and subject condition. A striking dissociation between (positive) effects on bone strength and (variable) effects on bone stiffness was repeatedly observed in these studies. Also an enla

Animals↗
PubMed1998

[Avoid the mouse-trap! Musculoskeletal injuries can be reduced by placing the mouse within shoulder space].

Somewhat more than 50 per cent of computer operators complain of problems in the neck, shoulders or arms. A possible source of such problems may be manipulation of the mouse. Women are more susceptible than men, possibly due to their smaller physical size and muscle power. With the mouse placed to the side of the keyboard, narrow-shouldered computer operators must lift their arm and turn it sharply outwards. It is preferable to place the mouse within the span of the shoulders and rest the entire forearm on the desk. A shorter keyboard might be the answer for narrow-shouldered people.

Computer Peripherals↗
PubMed1998

Relation between image-based assessment of distal radius trabecular structure and compressive strength.

OBJECTIVE: To investigate the degree to which an image-based assessment of trabecular bone structure can predict bone strength. METHODS: Transaxial high-resolution magnetic resonance imaging (MRI) images and peripheral quantitative computed tomography (pQCT) images were obtained for a set of 9 isolated radii. Trabecular bone was segmented from fat, and indices relating to the connectivity of the bone network and the size of the marrow space were derived. Bone mineral density was also assessed in each radius by means of dual-energy x-ray absorptiometry and pQCT. Each bone was subjected to a mechanical load consistent with a fall from a standing height, and measures of density and trabecular structure were compared to the compressive load. RESULTS: In the 9 bones tested, measures of bone mineral density explained approximately 50% of the variability with load (0.52 < r2 < 0.57, p < 0.03), and indices relating to the size of the marrow spaces explained an additional 25% to 30% of the variance. This held true whether the indices quantifying the marrow space were derived from the MRI images (r2 = 0.70, p = 0.03) or the pQCT images (r2 = 0.82, p = 0.006). CONCLUSION: Our findings suggest that image-based assessments of trabecular bone structure relate to bone strength in vitro.

Absorptiometry, Photon↗