Choosing a computer system.
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Biomedical subjects
Publications and source records attributed to A Daniels.
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Lists of patients receiving repeat prescriptions for epilepsy, diabetes, thyroid disease and asthma were compared with chronic disease registers stored on seven practice computers. Diabetes was the most accurately recorded disease: the names of 72% of patients receiving medication for this condition appeared on the relevant disease registers. Agreement between the two data sources was 68% for thyroid disease, 58% for asthma and 49% for epilepsy. The levels of accuracy are not yet high enough for the computerised chronic disease registers to provide an accurate estimate of the prevalence of these conditions, but new system developments suggest a more optimistic outlook for the future.
The effect of antimicrobial prophylaxis on tolerance to hepatic embolization and chemoembolization with collagen particles was examined in porcine liver. Embolization in the 36 animals consisted of hepatic artery injection of 3 mL of collagen (10 mg/mL) alone or combined with one to three drugs (cisplatin, mitomycin, and doxorubicin). Embolization was performed with or without antimicrobial protection, and the animals were killed at 5 days for gross and histologic evaluation of liver and for bacterial culture. When present, liver damage consisted of focal to whole-lobe necrosis. Liver damage was correlated with positive bacterial culture (P less than .002) and was reduced by antimicrobial protection. Vessel recanalization was inhibited by addition of drug to collagen (P less than .001) and by lack of antimicrobial protection (P less than .001). Perivascular necrosis was directly related to vessel size (P = .0001). Antimicrobial prophylaxis is recommended to enhance hepatic chemoembolization safety.
Renal platinum distributions were determined in rabbits after administration of 0.4 mL of 1 mg/mL cisplatin by intravenous infusion, by injections into the left renal artery with aqueous contrast material and with lipid contrast material (Ethiodol), and by chemoembolization of the left renal artery with concurrent administration of various concentrations of two collagen carriers, Angiostat collagen for embolization and Gelfoam gelatin. Renal platinum concentration was measured in tissue homogenates at 2 1/2 hours with atomic absorption spectrometry. Target-kidney platinum levels were 5.4 and 6.9 times the contralateral-kidney levels after intraarterial infusion of aqueous and lipid contrast media, respectively. With Angiostat and Gelfoam chemoembolization, renal platinum retention and collagen concentration were linearly related (r = .87 and .81, P less than .001). Target-kidney-contralateral-kidney platinum ratios were 57:1 for 30 mg/mL Gelfoam and 220:1 for 10 mg/mL Angiostat. The difference in regional drug retention for Angiostat versus Gelfoam reflects the stable fiber integrity of Angiostat.
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