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Biomedical subjects

C Friedman

Publications and source records attributed to C Friedman.

17 recordsLinked to original sources
PubMed1992

Tolerating spelling errors during patient validation.

Misspellings, typographical errors, and variant name forms present a considerable problem for a Clinical Information System when validating patient data. Algorithms to correct these types of errors are being used, but they are based either on a study of frequent types of errors associated with general words in an English text rather than types of errors associated with the spelling of names, or on errors that are phonologically based. This paper investigates the types of errors that are specifically associated with the spelling of patient names, and proposes an algorithm that effectively handles such types of errors. This paper also studies the effectiveness of several relaxation techniques and compares them with the one that is being proposed.

Algorithms↗
PubMed1992

The UMLS coverage of clinical radiology.

The informational content of clinical radiology reports was examined to determine the coverage of the Unified Medical Language System (UMLS) in relation to the terminology used by physicians in the Radiology Department of Columbia Presbyterian Medical Center (CPMC). The UMLS semantic network contained 17 semantic types which were compatible with the types of clinical information in the reports. The type of semantic categories missing from the UMLS consisted mainly of modifier information relating to certainty, degree, and change type of information. This type of information formed a substantial part of the domain. Although most of the informational categories were found in the UMLS semantic network, most of the domain terms were not. Our results strongly suggest that the UMLS could be a significant tool for developing clinical text processing applications if it were extended to cover clinical domains.

Evaluation Studies as Topic↗
PubMed1992

Testing spatial understanding of anatomy.

A system was designed to test the medical student's ability to recognize and locate anatomical cross-sections. The computer was used to prepare the data, present the test and track the user's responses. The nature of the test was such that it could be prepared, presented and used much more easily on the computer than on paper. The system was used successfully by anatomists and medical students.

Anatomy↗
PubMed1991

Mediastinitis following coronary artery bypass surgery: a 3-year review.

Twenty cases of mediastinitis after coronary artery bypass graft operations in 1985-1987 were reviewed to determine risk factors. Two distinct clusters with a methicillin-resistant Staphylococcus aureus (MRSA) strain occurred in 1986. One resident was exposed to six cases but to only 5 of 24 controls (P less than .008). Cultures of his nares in January and November 1986 revealed the same MRSA strain as that of the cases. An attempt to eradicate the resident's nasal carriage of MRSA in January 1986 failed; eradication of his carrier state was achieved only after treatment with mupirocin. In a case-control study examining patients exposed to the resident, a prolonged duration of surgery (P less than .05) and a preoperative albumin level of less than 3.0 g/dl (P less than .009) were associated with mediastinitis with this MRSA. For the other 14 mediastinitis patients, who were not exposed to the resident, a preoperative albumin level of less than 3.0 g/dl was also a risk factor (8/14 cases vs. 8/43 controls, P less than .009). Thus, this study suggests that it is important to follow MRSA disseminators and to recognize that preoperative serum albumin levels are a risk factor for mediastinitis.

Carrier State↗
PubMed1991

Effects of low-dose cimetidine on nocturnal acid secretion in healthy subjects.

The effects of 100 mg and 200 mg bedtime doses of cimetidine on nocturnal gastric acid secretion were examined in nine healthy subjects in a double blind, placebo controlled, randomised three way crossover study. Treatment was given at 23.00 hours and the gastric contents continually aspirated from midnight until 07.00 hours the following morning. Hourly aliquots were analysed for pH and acid output. Relative to placebo the 100 mg and 200 mg doses of cimetidine respectively increased mean pH by 2.22 and 2.63 units/h (P less than 0.001) with mean acid output decreasing by 0.95 and 0.98 mmol/h (P less than 0.001). Whilst mean pH was higher and mean acid output was lower for 200 mg cimetidine compared to 100 mg cimetidine the difference was not statistically significant. Mean hourly pH was consistently above pH 3 for 100% of the time for both doses of cimetidine whereas mean pH failed to reach this value at anytime on placebo. Low doses of cimetidine taken at bedtime effectively reduced nocturnal gastric acid secretion in healthy individuals.

Administration, Oral↗
PubMed1991

Pericentric inversion of the X chromosome: presentation of a case and review of the literature.

A large pericentric inversion of the X chromosome [inv(X)(p22.31q26.3)] was found to be transmitted in four generations through phenotypically normal males and females. In one female carrier, the inv(X) was late replicating in 70% of lymphocytes and 46% of skin fibroblasts. Steroid sulfatase (STS), an enzyme which normally escapes inactivation has been located to Xp22.32 and, in our case, has been moved to an aberrant position. We have assayed its activity in clones with the inv(X) inactive or the normal X inactive and found no significant differences. Thus, the STS locus escaped X inactivation in both the normal and the inverted X chromosomes. A review of the literature shows that almost half of the breakpoints on the short arm are found at region p22 and we propose that low-copy repetitive DNA segments along the X chromosome are responsible for non-homologous pairing and production of inversions.

Amniocentesis↗
PubMed1991

Conceptual data model for a central patient database.

This paper presents methods used to develop a conceptual model for a patient database forming the centerpiece of a clinical information system under development. Various modeling techniques are discussed using a simplified fragment of the model. A method for mapping the model onto a relational design optimized for single patient retrievals is described. The results section discusses a number of issues pertaining to the flexibility and usability of this architecture.

Databases, Factual↗
PubMed1991

Validating patient names in an integrated clinical information system.

Methods for validating patient names during the upload of clinical records are described. Exact string matching, Soundex method and a pattern matching algorithm (LCS method) are described and compared to a manual analysis of 10000 patient name pairs. In addition, the types of spelling and typographical errors that occur in patient names in the pathology database at CPMC are described. The data analysis shows that the LCS method performs better than the other techniques when compared to manual analysis.

Algorithms↗
PubMed1990

Intraoperative radiation of canine carotid artery, internal jugular vein, and vagus nerve. Therapeutic applications in the management of advanced head and neck cancers.

As a step in the application of intraoperative radiotherapy (IORT) for treating advanced head and neck cancers, preliminary information was obtained on the radiation tolerance of the canine common carotid artery, internal jugular vein, and vagus nerve to a single, high-dose electron beam. Both sides of the neck of eight mongrel dogs were operated on to expose an 8-cm segment of common carotid artery, internal jugular vein, and vagus nerve. One side of the neck was irradiated, using escalating doses of 2500, 3500, 4500, and 5500 cGy. The contralateral side of the neck served as the unirradiated control. At 3 and 6 months after IORT, one dog at each dose level was killed. None of the dogs developed carotid bleeding at any time after IORT. Light microscopic investigations using hematoxylin-eosin staining on the common carotid artery and internal jugular vein showed no consistent changes that suggested radiation damage; however, the Masson trichrome stain and hydroxyproline concentration of irradiated common carotid artery indicated an increase in the collagen content of the tunica media. Marked changes in the irradiated vagus nerve were seen, indicating severe demyelination and loss of nerve fibers, which appeared to be radiation-dose dependent. Four patients with advanced recurrent head and neck cancer were treated with surgical resection and IORT without any acute or subacute complications. The role of IORT as a supplement to surgery, external beam irradiation, and chemotherapy in selected patients with advanced head and neck cancer needs further exploration.

Animals↗
PubMed1990

Hemodialysis-associated febrile episodes: surveillance before and after major alteration in the water treatment system.

Surveillance for bacteremic or pyrogenic episodes associated with hemodialysis was undertaken before and after the reconstruction of the water treatment system at our University medical center. The new water system included a holding tank with iodination treatment. The water delivered to individual dialysis stations had only occasional positive bacterial cultures (3 of 21 samples before completion of construction, 2 of 16 samples afterwards) and intermittent detection of endotoxin (6 of 21 samples before completion of construction, 9 of 16 samples afterwards) at monthly sampling. Among 51 individual dialysis treatments (25 patients) before reconstruction and 56 treatments (29 patients), after, only 2 and 3 febrile events were identified, respectively. All of these were associated with underlying infectious illness and not with the hemodialysis procedure itself. Overall, we conclude that pyrogenic episodes associated directly with hemodialysis treatment are infrequent, and that the addition of a water storage tank with iodination treatment does not appear to increase the risk of bacteremia or pyrogenic episodes.

Academic Medical Centers↗
PubMed1989

Treatment of hidradenitis suppurativa with combination hypothalamic-pituitary-ovarian and adrenal suppression. A case report.

A 33-year-old woman with severe familial hidradenitis suppurativa of the vulva and perineum was treated with a combination of dexamethasone and a new synthetic gonadotropin releasing hormone agonist, leuprolide acetate. The clinical improvement paralleled the adrenal and ovarian suppression, as demonstrated by falling blood levels of testosterone, dehydroepiandrosterone sulfate, androstenedione and estradiol.

Adult↗
PubMed1978

Tumors of the head and neck. A 4-year study of a multidisciplinary approach.

A multidisciplinary conference composed of the essential medical, surgical, dental, and allied specialists involved in the region of the head and neck, with resources to call upon other contributors when necessary, was undertaken at a major teaching center in the Northeastern U.S.A. (Long Island Jewish Hillside Medical Center). Meeting on a bimonthly basis with referrals accepted from all sources, but non-publicized, a total of 343 patients were seen over a period of 50 months. The results indicate that optimum patient care can be achieved with a minimum loss of time for treatment initiation and substantial cost savings from these specialists meeting as a group.

Age Factors↗
PubMed1976

Pituitary responses to LRH in the postpartum periods.

Pituitary responses to luteinizing-hormone-releasing-hormone (LRH) in the postpartum periods were studied. Following a subcutaneous injection of 100 mug of synthetic LRH to postpartum subjects, no statistically significant changes in the levels of LH and FSH could be demonstrated in five subjects on postpartum day 1 or 3 and the three subjects on postpartum day 8. A normal elevation of LH and FSH following LRH was demonstrated in one subject 36 days post partum. The findings are in agreement with previous studies demonstrating a persistence of pituitary suppression during the early postpartum period. No correlation could be drawn between the pituitary responses to LRH and the plasma levels of estradiol-17 beta and progesterone.

Estradiol↗