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PubMed2006

Computational vision systems for the detection of malignant melanoma.

In recent years, computational vision-based diagnostic systems for dermatology have demonstrated significant progress. We review these systems by first presenting the installation, visual features utilized for skin lesion classification and the methods for defining them. We also describe how to extract these features through digital image processing methods, i.e. segmentation, registration, border detection, color and texture processing, and present how to use the extracted features for skin lesion classification by employing artificial intelligence methods, i.e. discriminant analysis, neural networks, and support vector machines. Finally, we compare these techniques in discriminating malignant melanoma tumors versus dysplastic naevi lesions.

Automation↗

PubMed1984

The design of a computer-assisted education system using a CT scanner computer.

The minicomputer that is part of a commercial CT scanner has been used to develop a general purpose computer-assisted education system. This allows instruction in radiology using the CT computer already installed in the radiology department. The computer software was designed as a course interpreter, allowing the courses themselves to be written in English. Images and educational text are stored on separate disk files and displayed by the interpreter.

Computer-Assisted Instruction↗

PubMed2002

Early experience with robotically assisted internal thoracic artery harvest.

We sought to determine the efficacy of using robotic assistance to facilitate endoscopic harvesting of internal thoracic arteries (ITAs). A total of 104 patients had ITAs harvested endoscopically with use of both the AESOP 3000 system (Computer Motion, Goleta, CA, U.S.A.) and Zeus robotic telesurgical system (Computer Motion). All ITAs were harvested with a harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH, U.S.A.). With the left lung collapsed, ITAs were harvested with CO2 insufflation through three 5-mm ports in the left chest. All patients tolerated insufflation without hemodynamic compromise. Average ITA harvest time was 61.3 +/- 20.9 minutes. Intraoperative graft flows averaged 36.3 +/- 22.4 mL/min. There were three distal ITA injuries; all other vessels were patent after harvesting and demonstrated no angiographic evidence of injury. This article demonstrates a technique by which ITA can be safely harvested totally endoscopically with use of computer-enhanced robotic systems and a harmonic scalpel, allowing complete pedicle dissection through 5-mm ports with minimal ITA manipulation.

Aged↗

PubMed2004

The integration of the computer advisory system together with neuroimaging procedures, neurophysiological markers and psychological cognitive tests in order to obtain evidence based system for the physician treating affective disturbance.

WHO has classified depression disturbances--due to widespread existence and serious medical consequences and resulting social and economic effects--as a priority health problem in all the developed countries. The significance of the depression disturbances is fully comparable to such illnesses as heart diseases, cancer and HIV infection. The research made in the USA (NIMH programmer) shows that first contact doctors are not able to detect depression in relation to 50-70% of the people ill with it. Also the research made in other countries shows that a doctor properly identifies only one out of four persons with clear indications of depression. The wrong choice of the antidepressant drug may result in inefficient therapy and in growing risk of suicide. In 1993 the analysis of 50 best selling medicines in the EU made by two Italian pharmacologists showed that in France and Italy in over 45% of the cases the medicines with doubtful efficiency are applied. The aim of our project is to build a European network, which will integrate the research capabilities of a group of research institutes and university departments to provide an infrastructure for creation of the computer advisory system for diagnostics of affective disorders. This network will integrate our original computer expert advisory system called "Salomon" with modem brain imaging techniques and neurophysiological methods, which allows for the delineation of specific subtypes and particular episodes of mental disorders and their neural bases will be studied by state-of-the art (high tech) imaging techniques. This approach will lead to new investigatory, diagnostic and therapeutic techniques.

Antidepressive Agents↗

PubMedDate not supplied

Using computer-aided systems to provide patient information.

Patient information should be tailored to suit the learning style of each person. Benefits and constrains of the method of information delivery should be taken into consideration. Using computer-aided systems to provide for patients' information needs is not a new concept. Studies have shown positive results in well-being when such systems are used and nurses act as facilitators.

Computer-Assisted Instruction↗

PubMed1998

Computer information systems in Ohio home care agencies.

Computerized information management is increasingly critical for home care agencies. Yet little is known of computer capabilities currently available in home care agencies. Findings from one study indicate that computer support for clinical services is considerably less developed than for administrative services and that agencies plan major expansions of computerized clinical support.

Computer Systems↗

PubMed2006

[Advances in soft tissue management in total knee arthroplasty. The use of imageless navigation systems].

Computer aided surgery has become established in the clinical routine over the past years. There are some very good studies which show that navigation optimizes reconstruction of the leg axis in total knee replacement. The question of why outliers occur in spite of navigation has to be asked. It is clear that total knee replacement is not only a bony procedure, but the soft tissues have an immense influence on postoperative stability of the prosthesis over the full range of movement. Current navigation systems allow visualization of the leg axis and size of the extension and flexion gap, and support the surgeon during soft tissue management. The current paper shows how the anatomic approach and the position of the patella influence soft tissue tension and support the surgeon during release of soft tissues in severe leg axis deformities.

Arthroplasty, Replacement, Knee↗

PubMed2000

Planning system for computer assisted total knee replacement.

Total knee replacement (TKR) is a common orthopaedic surgical intervention and includes the removal of bone sections from the end of the femur and the top of the tibia for replacement by prosthetic components. Pain relief and functional improvement are predictable clinical results. But the accuracy of the alignment affects the surgical outcome and the longevity of the prosthesis. Hence, current total knee implantation systems attempt to align the knee joint in the mechanical axis for placement of the total knee components. These approaches use templates and plain radiographs for preoperative planning and alignment devices for bone cuts. To overcome the inherent inaccuracy of the presently used systems a computer-assisted planning system has been developed delivering the necessary control data for the intraoperative surgical robot system.

Arthroplasty, Replacement, Knee↗

PubMed2005

The Webcam system: a simple, automated, computer-based video system for quantitative measurement of movement in nonhuman primates.

Investigations using models of neurologic disease frequently involve quantifying animal motor activity. We developed a simple method for measuring motor activity using a computer-based video system (the Webcam system) consisting of an inexpensive video camera connected to a personal computer running customized software. Images of the animals are captured at half-second intervals and movement is quantified as the number of pixel changes between consecutive images. The Webcam system allows measurement of motor activity of the animals in their home cages, without devices affixed to their bodies. Webcam quantification of movement was validated by correlation with measures simultaneously obtained by two other methods: measurement of locomotion by interruption of infrared beams; and measurement of general motor activity using portable accelerometers. In untreated squirrel monkeys, correlations of Webcam and locomotor activity exceeded 0.79, and correlations with general activity counts exceeded 0.65. Webcam activity decreased after the monkeys were rendered parkinsonian by treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), but the correlations with the other measures of motor activity were maintained. Webcam activity also correlated with clinical ratings of parkinsonism. These results indicate that the Webcam system is reliable under both untreated and experimental conditions and is an excellent method for quantifying motor activity in animals.

Animals↗

PubMed1991

A computer-based system for controlling plasma opioid concentration according to patient need for analgesia.

Microprocessor-controlled infusion pumps, which allow a patient to self-administer bolus doses of an analgesic to relieve pain, are becoming commonplace. While these patient-controlled analgesia (PCA) systems overcome the large interpatient variations in pharmacokinetics, they do not provide steady relief from pain since they rely on delivering a drug in small, incremental doses. To overcome this problem, the authors developed an algorithm and computer-pump system that allows patients to control their own plasma concentration of analgesic. This approach uses individually predetermined pharmacokinetic parameters to provide steady plasma opioid concentrations that can be increased or decreased by the patient in line with the need for more pain relief or fewer side effects. The control software uses a novel, recursive algorithm to compute the pump rates necessary to maintain constant plasma drug (e.g. morphine) concentrations at desired values and to reach a new steady concentration in response to patient requests. This report describes the mathematical approach to the problem of control of plasma opioid concentration, the application of this new drug delivery system to management of persistent pain in cancer patients undergoing bone marrow transplantation, and the magnitude of pharmacokinetic variability with morphine in this patient population. Results are presented from individual patients using this adjustable drug delivery system continuously for up to 2 weeks to control pain from oral mucositis.

Analgesia, Patient-Controlled↗

PubMed1986

Cardiology office computer use: primer, pointers, pitfalls.

An office computer is a utility, like an automobile, with benefits and costs that are both direct and hidden and potential for disaster. For the cardiologist or cardiovascular surgeon, the increasing power and decreasing costs of computer hardware and the availability of software make use of an office computer system an increasingly attractive possibility. Management of office business functions is common; handling and scientific analysis of practice medical information are less common. The cardiologist can also access national medical information systems for literature searches and for interactive further education. Selection and testing of programs and the entire computer system before purchase of computer hardware will reduce the chances of disappointment or serious problems. Personnel pretraining and planning for office information flow and medical information security are necessary. Some cardiologists design their own office systems, buy hardware and software as needed, write programs for themselves and carry out the implementation themselves. For most cardiologists, the better course will be to take advantage of the professional experience of expert advisors. This article provides a starting point from which the practicing cardiologist can approach considering, specifying or implementing an office computer system for business functions and for scientific analysis of practice results.

Cardiology↗

PubMed1992

A mainframe interfacing computer management system for the control of oral anticoagulant therapy.

A unique computerized management system has been used to control the anticoagulation of over 400 patients at a large teaching hospital for the last eighteen months. The system is located on the main pathology computer which can be interfaced with the patient administration system (PAS). This enables files in the anticoagulant program to be linked with files in the PAS and files in the haematology database. This system has many advantages over a stand-alone microcomputer system and will form the basis for the next generation of computerized anticoagulant management systems.

Administration, Oral↗

PubMed2005

An integrated computer-based system to support nicotine dependence treatment in primary care.

The purpose of this study was to develop, implement, and evaluate the feasibility of an integrated computer-based system for tobacco-user identification and smoking cessation intervention for primary care patients in a medically indigent, managed care population. Interactive voice response (IVR) technology was used to screen for tobacco use prior to scheduled primary care visits at two inner-city clinics. The IVR system placed calls to 2,039 patients scheduled for clinic visits, and 1,086 (53%) patients completed the automated tobacco-use question set. Current smokers were identified in 421 (39%) of the calls. Computer-generated reminders for clinicians that incorporated information obtained from the automated calls were placed on all smokers' encounter forms. In a post-visit interview of 120 smokers, 58 participants (48%) reported that they discussed smoking cessation with their provider. Some 71% of participants agreed that use of the IVR system to obtain information was a "good way for patients to give information about their health to doctors." Automated capture of patient-reported data via IVR technology is a potentially useful strategy for tobacco-use screening in primary care.

Algorithms↗

PubMedDate not supplied

A theory-based computer training program.

Using Kolb's learning theory resulted in an effective method of implementing a computer training program. The variety of teaching strategies provided an environment for nurses and other health care providers with different learning styles to understand and use the computer system successfully. The comprehensive training program was critical to the successful conversion to a new computer system in this large public teaching hospital. This project reinforces the need for nursing education and research departments to use teaching strategies that accommodate a variety of learning styles in a heterogenous group. The results of this project suggest one approach to stimulate adult learning and facilitate an effective learning environment. Nurses and other computer users have demonstrated effectiveness of this training program through successful activation of the new computer system.

Computer User Training↗

PubMed1989

Development of an evaluation model for computer foodservice management systems.

Business evaluation practices were used to develop a model for postimplementation of a computer system in a foodservice. Four levels of success with a corresponding indicator for evaluation were identified as: I. Management Action--management implements data and reports; II. Management Change--management initiates use of system to find solutions to problems; III. Management Uses Analytical Approach--management uses system as a routine part of problem-solving; and IV. Management Change in Task-management's role changes as a result of the computer system. Five computer functions were identified for evaluation: integrity, performance, use, efficiency, and effectiveness. Criteria, measurements, standards, and actual sections were then developed for each function. An instrument was developed on the basis of the evaluation, including forms, questionnaires, learning experiences, and scenarios. The instrument was then applied to two computer foodservice management systems--a custom-designed system and a packaged software system. The instrument was applied to software systems by the scenario method. Five criteria with key indicators were developed to determine successful application of the instrument. The evaluation model and the final instrument developed and applied in this study should be useful to dietitians evaluating a computer system 6 to 12 months after implementation in their foodservice.

Computer Systems↗

PubMed1977

The effects of overdominance of linkage in a multilocus system.

Computer simulations were performed with overdominant muliple alleles among tightly linked multiple loci under a multiplicative fitness model. The quantity chi2/N (n--1) was introduced as a new measure of linkage disequilibrium which, unlike previously available measures, can be applied to multiple allele models, where N is the sample size, and n is the number of alleles at the locus possessing fewest alleles. Simulations showed that (1) With multiple (three or four) alleles, the approach to stable disequilibrium is slower and the amount of disequilibrium established is weaker than in a two allele system. (2) The number of complementary chromosomes is a function of number of alleles and of population size. (3) As population size increases, the rate of the approach to stable disequilibrium is slower. (4) There is an optimum selection coefficient which minimizes the transient fixation probability of alleles when linkage is present. (5) The absence of linkage disequilibrium is in most cases not a practical method of testing the hypothesis of balancing selection of genetic polymorphisms because it depends strongly on population size in determining linkage disequilibria.

Alleles↗

PubMed1983

Severe anaemia: its CT findings in the cardiovascular system.

Computed tomography of the upper abdomen and of the heart was performed in 21 patients with severe anemia (mean haematocrit value 0.23, mean haemoglobin content 39.6%). Gross morphology of the heart and great vessels (wall thickness, size of the chambers, lumina and walls of the vessels) were visualized in all patients without the use of contrast media. The smallest discernible difference between the normal heart muscle and blood filling its cavities was about 6-8 H and the smallest discernible difference between the aorta and the aortic blood was about 8-10 H (window width 150 H, window level 50 H). There were no CT signs of haemochromatosis of the heart, while CT measurements were highly suggestive of liver haemochromatosis in several cases. Visual evaluation of liver density in comparison to the density of blood in hepatic and portal vessels is misleading.

Adult↗

PubMed1991

Implementing computer information systems for hospital-based case management.

Like all health care services, case management is a process that relies on information. Based on the experiences in implementing computer information systems in six hospital-based case management programs, several financial, technical, and management issues are reviewed. These issues, which are also relevant for other specialized hospital-based programs, include information priorities, user acceptance, quantifying data, data entry methods, data security, and systems integration. The lessons learned regarding these issues are discussed, and categories of software alternatives are presented.

Arizona↗