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[Elements of medical scholasticism in The Secrets of Alex of Piemont].

In the Secrets of Alex of Piemont, a 16th century prescription book, originally published in Italian and soon after translated into eight European languages (including Polish) one can find curious enumerations of about twenty or even thirty different diseases which can be cured by only one medicine just described. Enumerations of this kind are possible to be find also in some other ancient and Middle Ages works on medicine. The author of the paper makes an attempt to find an explanation of such the curiositiy in Hippocrates' and Galen's humoral theory as well as in scholastic methods of teaching medicine in Middle Ages schools and universities.

Dispensatories as Topic↗

Mapping various information sources to a semantic network.

Giessen Data Dictionary Server (GDDS) provides context sensitive information services to disparate clinical applications by automatically navigating a semantic network that stores medical knowledge. Mapping multiple information sources to single clinical application becomes a challenge due to different organization of semi-structured information sources. Linking huge unstructured information sources such as medical literature is even more challenging because we need to develop a mechanism to organize unstructured information and take into account the scalability issue. In this paper, we have successfully mapped two drug information sources by developing an independent subnet for each source and linking them at proper nodes. For medical literature, we have demonstrated that the semantic network of the Unified Medical Language Systems and human assigned topics to each document can be used to organize the large amount of medical literature into the framework of the GDDS service.

Dictionaries, Medical as Topic↗

[Study of some official pharmaceutical preparations in the Sixth Edition of Formule Normales by thin-layer chromatography].

Pharmaceutical preparations--containing aminophenazonum, noraminophenazonum sodium mesylicum, acidum acetylsalicylicum and aethylmorphinium chloratum--official in the VI. Edition of Formulae Normales have been investigated. Simple method for studying decomposition products--which can be carried out in pharmacies and can be followed the quality of products with during their usability--has been developed. The method proving and precluding the presence of decomposition products, respectively by means of preparing dilution sets has been capable of semiquantitative determination of decomposition products. DC Alufolien Kieselgel 60 F254 (Merck) layer was used. Temperature of laboratory was 22-26 degrees C and its relative humidity was 30-40%. Developing solvents were: acetone-ether-water (90:15:12) for aminophenazum; benzene-acetone-90% alcohol-wated (35: 33: 26: 11) for noraminophenazonum sodium mesylicum; methenol-glacial acetic acid-ether-benzene (1: 18: 60: 120) for acidum acetylsalicylicum; dichloromethane-methanol-concentrated ammonia (85: 15: 2) for aethylmorphinium chloratum. Detections were carried out under UV light and by using colour reagents (alcoholic ninhydrine solution for aminophenazonum, dimethylamino-benzaldehyde solution for noraminophenazonum sodium mesylicum). Rf-values of intact and decomposed compounds have been given in figures. Interfering effects of other components of preparations were studied too. These components had different Rf-values or did not react with the colour producing reagents in the applied systems.

Chromatography, Thin Layer↗

Cefotaxime and ceftriaxone use evaluation in pediatrics. Considerations of cost effectiveness.

In 1993, there was a change from ceftriaxone to cefotaxime in the inpatient pediatric division of the Johns Hopkins Hospital. The annual cost savings resulting from this change were estimated. The educational efforts of the pediatric division pharmacists resulted in an increase in appropriate drug selection from 55% to 93%. The estimated annual cost saving was $18,618.

Bacterial Infections↗

Homeopathic products.

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Clinical Trials as Topic↗

The pharmacy as part of an integrated hospital information system: a focus on benefits.

An integrated hospital information system benefits not only the pharmacy but also each department within a hospital, including the physician and patient. The Composite Health Care System (CHCS) is a fully integrated healthcare information system that has been developed for the Department of Defense's medical treatment facilities. CHCS provides modules for Patient Administration, Patient Appointment Scheduling, Radiology, Laboratory, Pharmacy, and Physician/Nursing Order Entry and Results Retrieval, which serve to integrate inpatient wards, clinical services, administrative departments, and remote outpatient clinics. CHCS provides an integrated patient profile to care givers throughout the medical facility, improving the quality of their clinical decisions. The integrated hospital information system also helps to coordinate the delivery of patient care and automates many interdepartmental transactions, which allows for more efficient use of resources and increases the turnaround time for delivery of services. This article focuses on the system's pharmacy component to demonstrate the benefits realized with an integrated hospital information system.

Clinical Pharmacy Information Systems↗

Drug usage review of cefamandole at a teaching hospital.

A drug usage audit of cefamandole was conducted at a 900-bed teaching hospital. Health records of all in-patients receiving cefamandole during a three-month period (November 1, 1985 to January 31, 1986) were retrospectively reviewed. Treatment of lower respiratory tract infections accounted for 35 (44%) of the 79 treatment courses examined. Surgical antimicrobial prophylaxis for cardiovascular procedures involved 26 (33%) courses of therapy and 15 (19%) courses were associated with biliary tract procedures. The three remaining treatment courses (4%) included therapy for septicemia, orthopedic surgery prophylaxis, and a leg ulcer. Twenty-eight percent of all treatment courses were deemed to be appropriate. Thirty-two percent were considered controversial, and 40 percent inappropriate. The majority of the suboptimal use identified involved prescribing cefamandole for cardiovascular surgery prophylaxis. The role of cefamandole in the acute hospital setting is reviewed with reference to other available first, second and third-generation cephalosporins. General recommendations for its use are outlined.

Anti-Bacterial Agents↗

Adverse drug reaction reporting system: developing a well-monitored program.

The spontaneous reporting of adverse drug reactions (ADRs) at the St. John's Hospital and Memorial Medical Center was well below that reported in the literature. After review of procedures for reporting of ADRs at these institutions, the authors developed a system that was approved by their joint P & T Committee. The ADR reporting program developed uses concurrent monitoring of most hospital inpatients and a retrospective review of all emergency room patients. In the year after program implementation, 162 ADR reports were documented. From this program, a group of serious ADRs to one agent was identified and reported, both to the Food and Drug Administration and to the manufacturer. A well-developed ADR monitoring program may lead to heightened physician and nurse awareness and early problem identification, possibly decreasing morbidity for hospitalized patients.

Documentation↗

A semantic normal form for clinical drugs in the UMLS: early experiences with the VANDF.

A semantic normal form (SNF) for a clinical drug, designed to represent the meaning of an expression typically seen in a practitioner's medication order, has been developed and is being created in the UMLS Metathesaurus. The long term goal is to establish a relationship for every concept in the Metathesaurus with semantic type "clinical drug" with one or more of these semantic normal forms. First steps have been taken using the Veterans Administration National Drug File (VANDF). 70% of the entries in the VANDF could be parsed algorithmically into the SNF. Next steps include parsing other drug vocabularies included in the UMLS Metathesaurus and performing human review of the parsed vocabularies. After machine parsed forms have been merged in the Metathesaurus Information Database (MID), editors will be able to edit matched SNFs for accuracy and establish relationships and relationship attributes with other clinical drug concepts.

Algorithms↗