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Biomedical subjects

B A Allen

Publications and source records attributed to B A Allen.

16 recordsLinked to original sources
PubMed1996

A decision-supported outpatient practice system.

We describe a Decision-supported Outpatient Practice (DOP) system developed and now in use at the Columbia-Presbyterian Medical Center. DOP is an automated ambulatory medical record system that integrates in-patient and ambulatory care data, and incorporates active and passive decision support mechanisms with a view towards improving the quality of primary care. Active decision support occurs in the form of event-driven reminders created within a remote clinical information system with its central data repository and decision support system (DSS). Novel features of DOP include patient specific health maintenance task lists calculated by the remote DSS. uses of a semantically structured controlled medical vocabulary to support clinical results review and provider data entry, and exploitation of an underlying ambulatory data model that provides for an explicit record of evolution of insight regarding patient management. Benefits, challenges, and plans are discussed.

Ambulatory Care Facilities↗
PubMed1995

Lymphatic air embolism: a new hypothesis regarding the pathogenesis of neonatal systemic air embolism.

Objective. Neonatal systemic air embolism (NSAE) has been thought to result from introduction of air into the pulmonary veins through hypothesized alveolar-capillary fistula. The objective of this paper is to reassess the distribution of intravascular air visualized radiographically in this entity. Based on these data, an alternative theory for the pathogenesis of NSAE is proposed. Materials and methods. Four cases from our institutions and 21 additional reviewable published radiographs of NSAE were evaluated for the presence and location of intravascular air. Nonparametric statistical analysis was performed to determine if the predominance of intravascular air was venous or arterial in location, and to determine the presence or absence of pulmonary interstitial emphysema (PIE), pneumothorax, pneumomediastinum, and pneumopericardium. Results. Isolated systemic venous air was present significantly more often than isolated systemic arterial air (p < 0.0005). In addition, the presence of isolated right-sided cardiac air was found significantly more often than air within left heart chambers alone (p < 0.0005). PIE in patients with NSAE was found to be statistically more prevalent than pneumomediastinum or pneumopericardium, though similar in prevalence to pneumothorax. Conclusion. Our data support the hypothesis that intravascular air in NSAE is predominantly venous in location. PIE was found to be a very common associated finding in NSAE. Based on our current knowledge of pulmonary lymphatics, radiographic anatomy, and the lymphatic location of PIE, we propose that air within the pulmonary lymphatic system (PIE) gains access to the systemic venous system via lymphatic ducts, which results in the clinical entity NSAE. This readily explains the venous predominance of air in NSAE.

Embolism, Air↗
PubMed1991

Ventricular fibrillation complicating endomyocardial biopsy of a cardiac allograft.

Transvenous endomyocardial biopsy remains the most useful diagnostic aid in assessing rejection in the transplanted heart. Although invasive, the complications associated with endomyocardial biopsy are few, and the procedure is generally regarded as safe. We report a case of apparent ventricular fibrillation complicating transvenous endomyocardial biopsy. Histologic section revealed evidence of moderate acute rejection. This case represents the first report of a life threatening ventricular dysrhythmia following routine endomyocardial biopsy in a cardiac transplant recipient.

Cardiomyopathy, Dilated↗
PubMed1988

Rhythmic-movement facilitation of learning in working-class Afro-American children.

In this study, we examined whether the cognitive performance of working-class Afro-American children could be enhanced based upon a presumed knowledge of the Black cultural experience. Children (6 and 9 years old) learned to match each of 12 pairs of pictures via a rhythmic movement-coordinated procedure accompanied by a musical beat or through a rote recitation procedure. It was expected and found that subsequent retention of the picture matches was superior in the rhythmic movement condition. Moreover, for the younger children, the effect was stronger for those who came from homes providing high stimulation and who had high levels of movement expressiveness.

Black or African American↗
PubMed1985

Lifestyle assessment: applying microcomputers in family practice.

A randomised trial of assessment by computer was conducted with 180 patients in a family practice clinic. Histories of alcohol, tobacco, and drug use were obtained by computer (n = 60), interview (n = 60), or self completed questionnaire (n = 60). The results of previous research suggest that some patients may provide more accurate information about "sensitive" problems to a computer. No significant differences, however, in levels of consumption or problems were reported for the three methods of assessment. Patients gave differential ratings about the method of assessment, with the computer rated as more interesting but also more mechanical, cold, and impersonal. Although the interview was initially preferred by most, patients who completed the assessment by computer showed a significant increase (13% to 43%) in their preference for the computer after the assessment. The results of our study indicate that patients' acceptance of computers in family practice may be favourably influenced by direct experience with a microcomputer.

Computers↗
PubMed1985

Lifestyle assessment: just asking makes a difference.

A 10 minute assessment of 180 family practice patients showed that 11% indicated a problem with drinking alcohol, 20% with cigarette smoking, 36% with consumption of coffee or tea, and 3% with non-medical drug use, while 11% wanted to discuss their use of medications. Moreover, being asked questions resulted in a twofold or threefold increase in the patients' intentions of discussing such a problem with their doctor. Although there was good overall agreement in recognising a problem between the patient and doctor, in roughly 40% of instances where the patient indicated a problem the doctor was unaware of it. These patients tended to be young, well educated, and employed in professional occupations, and were on their first visit to the doctor. Such brief assessments of lifestyle should be routinely conducted in family practice for both case finding and prevention.

Adolescent↗
PubMed1980

Correlation between medical and behavioral data in the assessment of alcoholism.

Using the Munich Alcoholism Test, this study examined the prevalence and interrelationships of medical and sociobehavioral disorders in a nonhospitalized sample of 106 males who had been referred to a medical officer for "suspected" problems related to drinking. A further objective was to evaluate measurement properties of the Munich Alcoholism Test (MALT), a new diagnostic instrument for alcoholism. Self-report items focusing on the recognition of drinking problems formed a homogeneous and quite reliable scale. However, clinical signs and symptoms of disorders related to alcohol abuse occurred with relative independence of each other. In this predominantly young group of subjects, many individuals recognized that they had sociobehavioral problems, but few had clinical or laboratory manifestations of diseases associated with chronic alcohol abuse. These findings underscored the advantages of including both biomedical and sociobehavioral data for the early identification of alcohol abuse and dependence.

Adolescent↗
PubMedDate not supplied

CARTOS II semi-automated nerve tracing: three-dimensional reconstruction from serial section micrographs.

The paper describes the history of tracing activities in the Levinthal lab from 1965 to the present. It also focuses on the evolution of electron micrograph (EM) tracing from early hand tracing reconstruction to the current, nearly fully automated CARTOS II tracing system. The present hardware systems and tracing algorithms are described in detail. Also presented are the partial tracing results of one EM data set in two and three dimensions.

Algorithms↗