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PubMedDate not supplied

Prediction of accelerated Ca-induced Ca release rate by clinical findings in malignant hyperthermia susceptible subjects.

BACKGROUND: An abnormally accelerated Ca-induced Ca release (CICR) rate is known to be correlated with malignant hyperthermia susceptibility (MHS). OBJECTIVE: To analyze significant clinical findings concerning CICR rate and develop a computer program for its prediction in human MHS. PATIENTS AND METHOD: Using data from 146 subjects who had received a muscle biopsy for the determination of CICR rate, because of their anesthesia-related MHS history, we analyzed 23 different clinical features. There were 71 subjects with an abnormally accelerated CICR rate and 75 with a normal rate. Accelerated CICR rate was used as the objective variable whilst clinical findings and ages were used as independent variables and control variables, respectively. A multiple logistic regression model was employed for the analyses and the most suitable formulae for prediction were determined for use in the development of a computer program. RESULTS: The following 8 clinical findings were determined to be the most significant: the presence of muscle rigidity, the most serious PaCO2 reading (mmHg), peak body temperature (degree C), body temperature rate of increase over 15 minutes (degree C/15 minutes), most serious arterial pH reading, administration of dantrolene, improvement of acidosis with dantrolene, and time elapsed to peak body temperature after administration of anesthetics (minutes). By ranking the subject ages into 14 groups, we were able to minimize the prediction error rate with each corresponding formula. The computer program developed for prediction whilst consisted of these formulae yielded a sensitivity of 80% and a specificity of 86%. CONCLUSION: This method of prediction may contribute to the accurate prediction of CICR rate at the bedside. For clinical convenience, we will distribute the computer program upon request.

Acidosis↗
PubMed2004

A computer model of fractal myocardial perfusion heterogeneity to elucidate mechanisms of changes in critical coronary stenosis and hypotension.

Critical coronary stenosis (critical CS) alone does not lead to an alteration of fractal dimension (D) under resting conditions in a pig model, indicating undisturbed local myocardial perfusion. If critical CS is combined with hypovolemic anemia the resulting hypotension leads to a significant decline of D. The mechanisms involved in this phenomenon have not yet been elucidated. A computer program was developed enabling calculation of D for normal vascular trees, for single vessel coronary stenosis (CS), and for CS in combination with reduced coronary perfusion pressure (CPP). The values of D obtained by the computer program were compared to those available from an existing animal study to confirm that changes of D can largely be explained by changes of arterial branching pattern simulated by the computer program. Using our computer model, D was 1.15+/-0.06 in normal vascular trees. Third branch critical CS did not alter (1.14+/-0.06; n.s.), whereas critical CS combined with a reduction of CPP to 40 mmHg reduced D (1.07+/-0.03; P < 0.05). These data are comparable to those obtained in the animal study, and therefore show that alterations of vessel diameter and regional blood flow can largely explain changes of fractal dimension during critical CS and hypotension while changes of functional myocardial parameters might play a minor role.

Animals↗
PubMed2002

A prospective, randomized controlled study of computer-assisted learning in parasitology.

PURPOSE: To compare, using a prospective, randomized controlled study, three methods of teaching a medical school parasitology course: computer-based instruction, traditional lecture-based instruction, and a combination of computer-based and lecture-based instruction. METHOD: A single class of the University of Utah School of Medicine was randomized into three study groups for the second-year parasitology course. The computer group (n = 29) used a locally developed interactive parasitology computer program; the lecture group (n = 32) had traditional lectures, and the combined group (n = 33) used both the computer program and lectures. Students' knowledge was assessed using a pretest, a final examination, and a posttest administered four months after the course. Students also used logs to track the amounts of time they spent studying. Their impressions and course evaluations were collected using a standardized course-evaluation form. RESULTS: The groups' scores on the pretest, final examination, and posttest were not statistically significantly different. Students in the computer group averaged 26.8 hours of studying over the two-week course compared with 32.1 hours in the lecture group and 32.7 hours in the combined group. The difference in study times between the computer and combined groups yielded a significant p value of 0.036. Students were generally positive about the course and the computer program. CONCLUSION: Students can learn parasitology from computer-based instruction as effectively as from traditional lecture-based instruction, and they can do so in less time.

Adult↗
PubMed1984

Development of an interactive computer-videodisc program in pediatrics.

There is growing interest in the use of videodisc technology in health sciences education. This article describes the process of developing an interactive computer-videodisc program to teach health care professionals in training. It deals with techniques for examining infants with neuromotor problems. The program was developed at the University of Iowa and is the first of its kind to be used in pediatrics.

Computers↗
PubMed1982

Drug interactions: a study and evaluation of their incidence in Victoria.

This study attempted to quantify the incidence of drug interactions in general practice prescribing in Victoria. We used a computer program to search 428 prescriptions and associated medication records for possible interactions. We made 2445 drug/drug comparisons; the computer program generated 37 possible interaction alerts, none of which warranted a change in therapy. This type of computer program, unless extremely sophisticated, can only serve as a primary alert; a health professional should then check the validity of interactions it identifies.

Australia↗
PubMed1978

Dose distribution around a new flexible afterloading applicator.

A new afterloading applicatory, together with a computer program, is described. A comparison of the calculated and measured dose distribution around different applicators shows that in the future the described computer program can be used. The development of the new applicator and the computer program increases the flexibility of possible dose distribution.

Cesium Radioisotopes↗
PubMed1986

Epidemiologic programs for computers and calculators. Simple algorithms for the representation of deterministic and stochastic versions of the Reed-Frost epidemic model using a programmable calculator.

Two programs are described for the emulation of the dynamics of Reed-Frost progressive epidemics in a handheld programmable calculator (HP-41C series). The programs provide a complete record of cases, susceptibles, and immunes at each epidemic period using either the deterministic formulation or the trough analogue of the mechanical model for the stochastic version. Both programs can compute epidemics that include a constant rate of influx or outflux of susceptibles and single or double infectivity time periods.

Computers↗
PubMed1990

A multipurpose, computer-assisted program to improve ambulatory medical care: a preliminary report.

The multipurpose, computer-assisted Quality Care Program was developed to improve the quality of ambulatory medical care, streamline many physician and routine office functions, and enhance provider satisfaction with the medical practice. A unique patient encounter worksheet attached to the medical record at each office visit allows fast and accurate physician interaction with system functions, which include patient and physician reminders, outcomes monitoring, test tracking, patient education and communication, and practice assistance and analysis. The content of the system can be customized and edited, which allows for individualization by each medical practice.

Ambulatory Care Information Systems↗
PubMed1994

The process of cellular uptake of iron from transferrin. A computer simulation program.

In an attempt to improve our understanding of the complex interplay between cell compartments and chemical species during cellular uptake of iron from transferrin, we designed a computer simulation program based on current models of receptor-mediated endocytosis and pinocytosis. The program calculates and visualizes, as a function of time, the changes in transferrin, apotransferrin, and iron concentrations occurring in all relevant cellular compartments during cellular iron acquisition from transferrin. Simulation of literature data showed that the program generates results that are in accordance with experimental data. Furthermore, from measurements of the uptake of [carboxyl-14C]dextran we could utilize the program to suggest rate constants characteristic for the pinocytic process in rat reticulocytes. Moreover, simulations indicate that the apparent difference in the iron uptake process observed between reticulocytes and hepatocytes may be explained by the contribution made by pinocytosis to the iron uptake process. Finally, the present program should have potential as an educational tool during introduction to the field of receptor-mediated endocytosis in general and to cellular iron metabolism in particular.

Animals↗
PubMed2005

Effects of using a computer in a doctor's office on patient attitudes toward using computerized prompts in routine care.

BACKGROUND: We undertook this investigation to understand the effect of using a computer in a primary care setting on attitudes toward using computers to improve health services delivery. METHODS: In this analysis, we compared the acceptability data from the group of primary care patients from 10 community-based practices who did not use a computer program, and answered the questions hypothetically, with data from a group of patients who actually used a program such as one proposed in the survey taken by the first group of patients. Attitudes toward three uses of the program, screening, counseling and changing treatments were measured, as well as attitudes toward specific aspects of the program, such as security. RESULTS: The great majority of patients who used the program believed that the program was not too long (80.1%), was easy to use (82.3%) and that the questions were not hard to answer (75.7%). Also, on average only 20% of patients had concerns about the privacy and confidentiality of using the program. Patients who had used the computer program were significantly less likely to favor its use for screening [odds ratio (OR)=0.09, 95% confidence interval (CI)=0.04-0.19], counseling [OR=0.13 (95% CI=0.05-0.31)] and changing treatments for chronic conditions, such as hypertension [OR=0.12 (95% CI=0.07-0.23)]. Patients who felt that the computer took too long to use were less likely to favor its use for each of the three uses. CONCLUSIONS: Despite acceptability ratings that were high and consistent with ratings observed in other studies, exposure to the program significantly diminished support for using it in routine care. These findings highlight the need for measuring overall program acceptability in the context of a realistic use scenario and for correlating overall acceptability with acceptability of individual program components and attitudes, as a means for identifying opportunities for program improvement.

Adult↗
PubMedDate not supplied

Computer-assisted diabetes nutrition education increases knowledge and self-efficacy of medical students.

Medical students and physicians need to improve their understanding of the role of nutrition and the multidisciplinary team in diabetes care. To assist in this learning, an interactive computer program was developed that focused on prescribing diets for patients with diabetes. Parallel 10-item knowledge tests and an 8-item self-efficacy scale were used to evaluate the efficacy of the computer program among 41 third-year medical students. Mean knowledge scores increased significantly after using the computer program. Posttest knowledge scores for the medical students approached the level achieved by general practice dietitians with no diabetes specialty training. Mean self-efficacy scores increased significantly. The mean time spent on the educational component of the program was under 30 minutes. Computer-assisted diabetes nutrition education proved to be an efficient and effective method for teaching basic nutrition competencies to medical students. This program is available on the World Wide Web (http:/(/)medicine.aecom.yu.edu/diabetes/DEC.htm ) and may be a useful means for providing basic diabetes nutrition education to primary healthcare providers from a variety of disciplines as well as for medical students.

Computer-Assisted Instruction↗
PubMed1977

A computer analysis of cardiac electrograms.

Computer programs were constructed for the temporal analysis of 8 electrograms obtained from various regions of isolated dog hearts. The electrograms were recorded on photosensitive paper. A computer program written in the Fortran II language allowed an x-y digitizing table to be used to input the coordinates of each electrogram into a computer. Each electrode recording within a given cardiac cycle was digitized in this manner, and the temporal intervals between the 28 combinations of electrode pairs were calculated. The program also computed the heart rate and cardiac cycle length. Subroutine options permitted the grouping of data into experiment, record, and event numbers. All data were stored on a magnetic disk. A separate computer program written in the Fortran IV language performed basic statistical operations on each of the data files. The computer system described in the present report accurately and reliably processed over 10,000 cardiac cycles. Such a system can be used to analyze large amounts of data from sources other than electrograms. Temporal analysis of the standard electrocardiogram is offered as an example of the versatility of the programs.

Animals↗
PubMed1992

Developing computer training programs for blood bankers.

Two surveys were conducted in July 1991 to gather information about computer training currently performed within American Red Cross Blood Services Regions. One survey was completed by computer trainers from software developer-vendors and regional centers. The second survey was directed to the trainees, to determine their perception of the computer training. The surveys identified the major concepts, length of training, evaluations, and methods of instruction used. Strengths and weaknesses of training programs were highlighted by trainee respondents. Using the survey information and other sources, recommendations (including those concerning which computer skills and tasks should be covered) are made that can be used as guidelines for developing comprehensive computer training programs at any blood bank or blood center.

Journal Article↗
PubMed1990

Presurgical evaluation for dental implants using a reformatting program of computed tomography: maxilla/mandible shape pattern analysis (MSPA).

A new analysis technique that provides a shape pattern of the maxilla or mandible is described. This technique uses a software program of computed tomography multiplanar reformation (CT/MPR). The successive cross-sectional images obtained by the CT/MPR are numbered, and the height and width of the maxilla and mandible at each of these cross-sectional images at specified levels are measured. The measured height and width are plotted against the number of the cross-section. This technique, termed maxilla/mandible shape pattern analysis (MSPA), creates an easy profile of the shape of the maxilla and mandible, and it enhances treatment planning for the placement of dental implants.

Aged↗
PubMed1985

Localization of current dipole within a sphere by magnetic measurements.

The principal objective of this study is the development of computer programs to determine the location and strength of neural electric activity within the brain from noninvasive magnetic field measurements at the surface of the head. This report presents theoretical calculations and computer programs derived from the method described by Williamson and Kaufman to determine the depth and strength of a current dipole in a sphere. From the location of the magnetic field radial component extremes, Br maximum and Br minimum, the orientation and location of the current dipole can be determined. The accuracy of the solution is dependent on precise location of of the magnetic field extremes as measured from the surface of a sphere, e.g. the head. To validate the program for locating the dipole, theoretical calculations and computer programs related to the total magnetic field vector resulting from a hypothetical current source within a homogeneous sphere were generated. The errors in calculations of the current dipole depth and strength are presented.

Brain↗
PubMed1985

Paediatric anaesthetic management with the aid of a computer.

A computer program has been developed to assist in the preparation of proper drug and anaesthetic doses for children. An individualized reference sheet containing the doses of the more commonly used drugs for the induction and maintenance of anaesthesia, fluid requirements, blood volume information, ventilatory variables, estimated endotracheal tube sizes and emergency drug doses constitutes the output of this program. The importance of such a computer program in improving paediatric anaesthetic management is discussed.

Adolescent↗
PubMedDate not supplied

Plateletapheresis program. II. Computer selection of HLA compatible donors.

A rapid, cost-effective data entry and computerized matching system was developed for selection of HLA compatible cytapheresis donors for platelet-alloimmunized patients. The system was user-orientated with a computer-generated prompting system that facilitated program operation. Expansion of the number of compatible donors was achieved by treating splits and crossreactive HLA antigens as identical. By this mechanism, a 500-member donor pool easily supported the needs of a large patient population for single-donor cytapheresis platelets. An average of 3.4 compatible donors per patient was identified. For only two of the 48 (4%) thrombocytopenic recipients was transfusion support from the available donors inadequate to provide a posttransfusion platelet increment. At the end of 7 months, donation frequency for the 441 donors then in the pool averaged 2.0 +/- 2.4. This figure increased to 2.8 +/- 2.4 donations for the 176 panel members who actually underwent cytapheresis. Thus, the impact on donors participating in this program was not excessive.

Blood Donors↗