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Biomedical subjects

J R Scherrer

Publications and source records attributed to J R Scherrer.

At least 19 recordsLinked to original sources
PubMed1992

[Medical informatics as a complementary method in medical education].

The practice of the decision making at the bed side especially highlights the place to be devoted to medical informatics both at the pre- and post-graduate levels. Still in a relatively recent past, say the 50s-60s, most of the medical educational efforts were delivered when watching and then imitating the medical behaviour of an older physician. The medical educators were aware that besides the formal lessons related to selected chapters of medical textbooks, there were an obvious need for better training in the ability to make sound clinical judgements. If this ability has been considered only as an artful and intuitive process neither subjected to theoretical analysis nor to be captured in a formal quantitative model, now things have changed to such an extent that it becomes broadly shared that a science of medical decision making can be reasonably founded and this threefold: 1) Upon a formulated logic, 2) The probability theory, and 3) A value theory. The first gives the hand to artificial intelligence (AI) technics, the third to medical information data bases dealing either with patients (like in hospital information systems) or with literature like MEDLINE or electronic "cookbooks". Basically the probabilistic theory is based here upon a priori probabilities related to patients informations and data and opens the way to bayesian decision making. After this little summary it is stressed that educational informatics in medicine would appear either very central or very marginal, if not optional.

Computer-Assisted Instruction↗
PubMed1992

Natural language processing and semantical representation of medical texts.

For medical records, the challenge for the present decade is Natural Language Processing (NLP) of texts, and the construction of an adequate Knowledge Representation. This article describes the components of an NLP system, which is currently being developed in the Geneva Hospital, and within the European Community's AIM programme. They are: a Natural Language Analyser, a Conceptual Graphs Builder, a Data Base Storage component, a Query Processor, a Natural Language Generator and, in addition, a Translator, a Diagnosis Encoding System and a Literature Indexing System. Taking advantage of a closed domain of knowledge, defined around a medical specialty, a method called proximity processing has been developed. In this situation no parser of the initial text is needed, and the system is based on semantical information of near words in sentences. The benefits are: easy implementation, portability between languages, robustness towards badly-formed sentences, and a sound representation using conceptual graphs.

Abstracting and Indexing↗
PubMed1991

The MELANIE project: from a biopsy to automatic protein map interpretation by computer.

The goals of the MELANIE project are to determine if disease-associated patterns can be detected in high resolution two-dimensional polyacrylamide gel electrophoresis (HR 2D-PAGE) images and if a diagnosis can be established automatically by computer. The ELSIE/MELANIE system is a set of computer programs which automatically detect, quantify, and compare protein spots shown on HR 2D-PAGE images. Classification programs help the physician to find disease-associated patterns from a given set of two-dimensional gel electrophoresis images and to form diagnostic rules. Prototype expert systems that use these rules to establish a diagnosis from new HR 2D-PAGE images have been developed. They successfully diagnosed cirrhosis of the liver and were able to distinguish a variety of cancer types from biopsies known to be cancerous.

Biopsy↗
PubMed1991

TEXTINFO: a tool for automatic determination of patient clinical profiles using text analysis.

The clinical data contained in narrative patient documents is made available via grammatical and semantic processing. Retrievals from the resulting relational database tables are matched against a set of clinical descriptors to obtain clinical profiles of the patients in terms of the descriptors present in the documents. Discharge summaries of 57 Dept. of Digestive Surgery patients were processed in this manner. Factor analysis and discriminant analysis procedures were then applied, showing the profiles to be useful for diagnosis definitions (by establishing relations between diagnoses and clinical findings), for diagnosis assessment (by viewing the match between a definition and observed events recorded in a patient text), and potentially for outcome evaluation based on the classification abilities of clinical signs.

Databases, Factual↗
PubMed1990

From biopsy to automatic diagnosis.

High resolution two-dimensional gel electrophoresis is a very powerful biochemical tool for analysis of complex protein mixtures. In well defined situations, protein maps, obtained from tissue biopsies or biological fluids by this technique, can be automatically analyzed by computer. Some polypeptide patterns are the fingerprints of diseases. Applying clustering algorithm and learning techniques, the prototype expert system MELANIE recognized patterns and associated the correct diagnosis to the specific pattern.

Diagnosis, Computer-Assisted↗
PubMed1990

[New architectures destined for hospital computer networks opening the medical world to more communication facilities of every kind].

It is sound medical education discipline to ask for a review of the literature, patient to patient, before setting up any global appraisal or clinical judgement. Next it appears legitimate to conduct similar searches with a local or institutional data base management system to find similar local patients to be compared with those of the literature. Both actions need communication facilities to be rooted in the patient ward unit. It is shown how well the new workstations are suited to these communication expectancies, with an appropriate capability of providing a user-friendly human interface, international bibliographical research (such as MEDLINE), a remote computer assisted learning programme library, image manipulation and local medical records handling. It is also emphasized that the expectancies related to UMLS (Unified Medical Language System of the National Library of Medicine in Washington DC) or to telemedicine are closely dependent on the availability of the high networking performances now available.

Computer Communication Networks↗
PubMed1990

[Registration of detailed data in the medical record or how to translate "impressions" into measurable observations].

Every medical case record represents a mass of data (texts, pictures, figures, etc.) in an unstructured form. The physician needs to retrieve this data via several access routes: temporal (dependent on date or sequences of events), type of data (diagnostic, treatment, clinical signs, laboratory findings, image descriptors, all with their interrelationships), or depending on the severity of the disease, etc. Retrieval of this data fulfils several functions: circulation of a case record among specialists, assistance in summarizing a long and complex clinical course, comparison of patients, research, and teaching. Three projects are described which have the same aim: structuring of the case record in order to retrieve detailed data on patients as individuals and describe clinical courses on the basis of measurable observations. This structure must be understandable to a computer (directly or indirectly) so that searches and comparisons can be performed automatically. The first project, entitled "indexed paragraph prototype" reproduces the structure of the problem-oriented case record and is designed to input the Medical Outpatients Department's follow-up notes into the computer. The second, "automatic language analysis", aims to exploit two characteristics of medical language, its omnipresence in the case record and its reliability, in view of its status as the spontaneous vehicle of communication between physicians. The third, "collection of clinical signs during consultation", is based on a prospective collection of all elements of clinical observation, structured temporally consultation by consultation. The purpose of precise collection of detailed and measurable observations in individual patients is to identify those among the clinical signs which display the greatest power of discrimination, i.e. those which best serve to predict the case's evolution.

Abstracting and Indexing↗
PubMed1988

A prospective study of platelets and plasma proteolytic systems during the early stages of Rocky Mountain spotted fever.

We prospectively examined early changes in platelets and plasma proteolytic systems in 12 vaccinated and 6 unvaccinated volunteers in whom Rocky Mountain spotted fever developed after challenge with Rickettsia rickettsii. The platelet counts declined while the plasma concentration of beta-thromboglobulin and the ratio of beta-thromboglobulin to platelet factor 4 increased, indicating in vivo activation of platelets. Plasma levels of antithrombin III decreased and levels of fibrinopeptide A increased, indicating in vivo activation of the coagulation system. Plasma fibrinogen levels peaked at 24 hours and gradually declined; this is consistent with the behavior of fibrinogen as an acute-phase reactant. Prolongation of the prothrombin time and a decrease in plasma levels of factor VII in the absence of evidence of liver injury suggested possible activation of the extrinsic pathway of coagulation. A decline in plasma prekallikrein levels with an increase in plasma C1-inhibitor-kallikrein complexes suggested activation of kallikrein, probably through the intrinsic coagulation system. Elevations in levels of plasma fibrin-degradation products and alpha 2-antiplasmin-plasmin complexes with declines in plasminogen and alpha 2-antiplasmin levels provided evidence of activation of the fibrinolytic system. Elevated plasma levels of tissue plasminogen activator and von Willebrand factor reflected endothelial stimulation. Thus, even early in the course of Rocky Mountain spotted fever that is treated promptly, there is activation of platelets, coagulation pathways, and the fibrinolytic system. These changes may be related to endothelial perturbation, a major pathogenetic mechanism in the disorder.

Antithrombin III↗
PubMed1979

Model of hospital's inflow.

To be accepted as an inpatient in the Geneva Hospital one must proceed through a registration post. Data collecting sessions were set up there to study its working. Since many random components enter the registration procedure a stochastic queuing process is the appropriate model. The process main characteristics are determined by rather involved statistical and mathematical means. The values reckoned for the most relevant parameters (to both medical staff and general public) are found quite plausible.

Admitting Department, Hospital↗
PubMed1979

High density lipoprotein cholesterol in male relatives of patients with coronary heart disease.

To study factors that play a role in the familial occurrence of coronary heart disease, very low density lipoprotein (VLDL) triglycerides, low density lipoprotein (LDL) cholesterol and high density lipoprotein (HDL) cholesterol were measured after preparative ultracentrifugation in first degree male relatives of coronary patients and in control subjects. The HDL cholesterol concentration was significantly lower in relatives of 20--71 years old than in controls. No increase of serum and LDL cholesterol was found. A low level of HDL cholesterol was observed even in the younger relatives who are less likely to have cardiovascualr disease. In older relatives low HDL cholesterol was found in the presence or absence of clinical evidence of coronary artery disease. The HDL-cholesterol concentration was inversely related to the VLDL triglycerides both in relatives and controls, but the regression lines were different ((P less than 0.001) for the relative (y = --0.166x + 0.43) and for the controls (y = 0.191x + 0.49). A low HDL cholesterol level appears to be a marker of relatives of coronary patients.

Adult↗
PubMed1978

[Low HDL cholesterol in close relatives and patients with myocardial infarct].

Male patients aged 40 to 59 who had had acute myocardial infarction three months previously displayed a lower HDL cholesterol than the HDL cholesterol of an apparently healthy control group. The male first degree relatives of patients with acute myocardial infarction, like the patients with coronary disease, had a low HDL cholesterol which differed significantly from the HDL cholesterol of the control group. Low HDL cholesterol appears to be a better "marker" of patients with coronary disease and relatives of patients with acute myocardial infarction than serum cholesterol and triglycerides. The importance of low HDL' cholesterol could be related to the role of HDL in the cholesterol transport system from the peripheral tissues.

Adult↗
PubMed1978

[Measurement of human body fat by means of gravimetry. Application of Archimedes' principle].

The weighing of the human body under water is an application of Archimedes' law. Fat being lighter than water or than the structures of lean body mass, body fat can be measured by determining the specific gravity of the human body; that is, by underwater weighing. Body fat has been determined in an "ideal" sample of 14 men and 23 women, all aged 20 years. Testing against a reference measure of body fat makes it possible to test the validity of some anthropometric measurements and of some indices of obesity. These indices offer no advantages over anthropometric measurements.

Adipose Tissue↗