How to get the most out of the Internet for your clinical practice.
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Biomedical subjects
Publications and source records attributed to K J Ruskin.
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Internet teleconferencing software can be used to hold "virtual" meetings, during which participants around the world can share ideas. A core group of anesthetic medical practitioners, largely consisting of the Society for Advanced Telecommunications in Anesthesia (SATA), has begun to hold regularly scheduled "virtual grand rounds." This paper examines currently available software and offers impressions of our own early experiences with this technology. Two teleconferencing systems have been used: White Pine Software CU-SeeMe and Microsoft NetMeeting. While both provided acceptable results, each had specific advantages and disadvantages. CU-SeeMe is easier to use when conferences include more than two participants. NetMeeting provides higher quality audio and video signals under crowded network conditions, and is better for conferences with only two participants. While some effort is necessary to get these teleconferencing systems to work well, we have been using desktop conferencing for six months to hold virtual Internet meetings. The sound and video images produced by Internet teleconferencing software are inferior to dedicated point-to-point teleconferencing systems. However, low cost, wide availability, and ease of use make this technology a potentially valuable tool for clinicians and researchers.
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Electronic publication uses video, sounds, and pictures to present some ideas (e.g. characteristics of a heart murmur) that may be difficult to convey with printed text, and is changing the way in which physicians communicate.
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Explore the source record for details and available documents.
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Cerebral autoregulation and the blood-brain barrier are two important mechanisms that attempt to preserve brain homeostasis. The function of either may be disrupted by injury. When autoregulation is impaired, blood pressure and hematocrit determine cerebral oxygen delivery. Injury to the blood-brain barrier impairs brain volume regulation and may contribute to cerebral edema. The choice of intravenous fluid influences cerebral blood flow, cerebral oxygen delivery, brain metabolism, and brain volume.
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The development of the World Wide Web has led to an explosion of educational and clinical resources available via the Internet with minimal effort or special training. However, most of these Web pages contain only static information; few offer dynamic information shaped around clinical or laboratory test findings. In this report we show how this goal can be achieved with the design and construction of Medical Algorithm Web Pages (MAWP). Specifically, using Internet technologies known as forms and CGI scripts we demonstrate how one can implement medical algorithms remotely over the Internet's World Wide Web. To use a MAWP, one enters the URL for the site and then enters information according to the instructions presented there, usually by entering numbers and other information into fields displayed on screen. When all the data is entered, the user clicks on the SUBMIT icon, resulting in a new Web page being constructed "on-the-fly" containing diagnostic calculations and other information pertinent to the patient's clinical management. Four sample applications are presented in detail to illustrate the concept of a Medical Algorithm Web page: Computation of the alveolar-arterial oxygen tension difference using the alveolar gas equation; Computation of renal creatinine clearance; drug infusion calculation (micrograms/kilogram/minute); Computation of the renal failure index.
The enormous growth of the Internet and the World Wide Web has made these two technologies an important potential adjunct to cost-effective health care research and delivery. This article surveys some recent developments in telecommunications, networking and artificial intelligence that are likely to have a significant impact on improving the efficiency and quality of future health care. Issues discussed include: clinical record keeping on the Internet, Internet-assisted medical diagnosis, privacy and security matters, financial transactions, digital money, bandwidth concerns, multimedia (music, audio and video) information delivery via the Internet, intellectual property, and the concept of Information Philanthropy.
Networked electronic publication is a relatively new development that has already begun to change the way in which medical information is exchanged. Electronic publications can present ideas that would be impossible in printed text, using multimedia components such as sound and movies. Physicians who use the World Wide Web (WWW) on a regular basis may recognize the value of electronic publication and decide to become information providers. Nearly anyone with a computer and modem can create a WWW resource on a Web server at a hospital or on a commercial hosting service. Medical publication on the Internet demands a high level of quality control because the information will be available to anyone who cares to look. Creating a peer-review system for electronic information may, therefore, help to enhance academic recognition of Internet medical resources. Resources containing medical information must be continually available and protected from system failures and unauthorized access. As Internet technology matures and these problems are solved, electronic publication may become the predominant method of communication between medical professionals.