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Biomedical subjects

D Carugo

Publications and source records attributed to D Carugo.

5 recordsLinked to original sources

["ARCHIDIA": a system for patients' data collection and computerized filing. Part I. Methodology].

This report describes a computer based program of patient clinical data collection: the ARCHIDIA system. The project relies on descriptive analysis of clinical events according to well defined methodological criteria. This allows the formulation of a concise diagnosis which is, at the same time, exhaustive of all essential information. Two are the basis principles of this methodology: To define, as accurately as possible, the logical steps necessary to elaborate the diagnosis, that is construed by a sequence of codes. To define all the conditions that must be followed so to use any code in a controlled and independent way. These criteria were derived from literature. The major claim of the system is likely to be the introduction of a "common language" between different ICUs. Uniformed diagnostic and clinical criteria are the main source of large data collection for descriptive, analytic and prospective studies. After a one year pilot study performed by 4 ICUs, ARCHIDIA was used, in 1991, by 20 centers from the area of Milan, Pavia, Como, Varese (70% of total) and 4148 patient data were collected. A descriptive analysis will be reported in the following paper.

Electronic Data Processing

["ARCHIDIA": a system for patients' data collection and computerized filing. Part II. General description of a caseload].

OBJECTIVE: To describe a population of patients admitted in ICU in an homogeneous urban area by means of a computed system. EXPERIMENTAL DESIGN: Observational study. SETTING: 20 general intensive care units of general and university hospitals. PATIENTS: Patients admitted in ICU from 1-1-1991 to 31-12-1991. 3 centers collected patients only for 6 months, starting on 1-6-1991. MEASUREMENTS: For each patient demographic data, hospitalization data, outcome, diagnosis and diagnostic procedures used during hospitalization according to defined criteria previously described, were collected. Data have been collected on PC using dedicated software. RESULTS: All centers concluded data collection, none abandoned the study. General characteristics of 4148 valuable patients were reported. Age was 52.9 years, SAPS 12.4 and mortality 21.7%. The patients spent 8.7 days in ICU and, when transferred to a general ward, the following hospitalization was 21.5 days. CONCLUSIONS: Data collection demonstrated the project feasibility. It realizes a continue up to date system inside each unit and allows the use of a "common language" and homogeneous methodology between centers.

Adolescent

Reliability of the vestibulo-ocular reflex as an index of the effects of hypnotic drugs on the central nervous system.

The vestibulo-ocular reflex was tested after the administration of step doses of thiopentone or propanidid in 171 unpremedicated patients. The dose of thiopentone (3 mg kg-1) required to induce loss of nystagmus also abolished the response to verbal command. The dose required to inhibit the reflex in 95% of patients was 7.22 mg kg-1 and prevented adrenergic responses to nociceptive stimulation. The dose of propanidid required to induce loss of nystagmus was greater than that necessary to abolish response to verbal command. The reflex inhibition rate increased proportionally to the dose up to 8 mg kg-1; larger doses exerted a facilitatory effect and reduced the reflex inhibition rate. The vestibulo-ocular reflex is a reliable and sensitive means of demonstrating the different effects exerted by step doses of hypnotic drugs.

Adolescent

The treatment of hydrogen sulfide intoxication: oxygen versus nitrites.

A case of severe H2S intoxication, treated with oxygen, respiratory support and thiopental cerebral protection, is presented. The usual antidotal treatments using nitrites or oxygen are discussed, examining the risks of nitrite use and the efficacy of oxygen. The successful outcome of the case presented suggests that H2S poisoning be treated with oxygen and vigorous organ supportive care.

Adult