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[Development of software for data analysis by therapeutic drug monitoring of teicoplanin, a glycopeptide antibiotic].

We developed a new software named TEICTDM based on the Bayesian estimation utilized in the therapeutic drug monitoring (TDM) of teicoplanin, a glycopeptide antibiotic, for the estimation of individual pharmacokinetic parameters. Therefore, it is necessary to input more than one plasma concentration(s) determined in individual patient. Individual pharmacokinetic parameters were calculated by a least squares methods, MULTI2 (BAYES). Two-compartment model was applied to determine individual pharmacokinetic parameters in male healthy volunteers in Japan, and the relationship between clearance of teicoplanin and creatinine clearance in adult patients with various degrees of renal impairment in Europe was used. A series of work from data input to graph drawing or printing of results could efficiently carried out with the best of use of this software, suggesting that this software is now available in clinical practice.

Adult↗

Software agents in surgery: an update.

Intelligent and, thus, autonomously reacting software programs are capable of handling a lot of different tasks as has been realized in economics and network administration. The same so-called software agents can be used for a variety of organizational tasks in medicine. Some software agents already manage an individual patient's health care record from documentation to ambulant or stationary admission, surgical planning, and many other tasks which currently consume more than half of a physician's daily working time. Hence, not only a large potential of time, but also of economical savings result to the physicians' new disposition.

General Surgery↗

Developing multimedia software and virtual reality worlds and their use in rehabilitation and psychology.

The multimedia and virtual reality projects performed at our laboratory during the last ten years can be grouped into the following groups: 1) tutorial and entertainment programs for handicapped children, 2) rehabilitation programs for stroke patients and patients with phobias. We have developed multimedia software for handicapped children with various impairments: partial vision, hearing difficulties, locomotive difficulties, mental retardation, dyslexia etc. In the present paper we show the advantages of using multimedia software to develop mental skills in handicapped people and deal with the special needs of handicapped children. For the rehabilitation of stroke patients we have developed a computer-controlled method, which enables - contrary to methods used internationally - not only the establishment of a diagnosis, but also measurement of therapy effectiveness: 1) it enables us to produce a database of patients, which contains not only their personal data but also test results, their drawings and audio recordings, 2) it is in itself an intensive therapeutic test and contains tutorial programs. We are currently collecting test results. We have also developed some virtual worlds for treating phobias: a virtual balcony and a ten-story building with an external glass elevator as well as an internal glass elevator in the virtual Atrium Hyatt hotel. We have developed a virtual environment for treating claustrophobia too: a closed lift and a room where the walls can move. For specific phobias (fear of travelling) we have modelled the underground railway system in Budapest. For autistic children, we have developed virtual shopping software too. In this paper we present the advantages of virtual reality in the investigation, evaluation and treatment of perception, behaviour and neuropsychological disorders.

Child↗

Automated measurement of intima-media thickness of carotid arteries in ultrasonography by computer software.

PURPOSE: Intima-media thickness (IMT) has been proposed to be a morphological criterion of atherosclerosis. The purpose of this study was to investigate the interobserver variability of manual and also of computer software measurements of IMT. MATERIALS AND METHODS: High-resolution common carotid artery (CCA) images of 88 patients that have been obtained by a linear broadband L5-12 MHz transducer and archived in PACS were retrospectively evaluated. Two separate investigators, who were unaware of the former results, evaluated the same images by using computer software that had a dedicated tool for automatic measurement of IMT. The results of the investigators were compared. RESULTS: According to the two investigators who have performed manual measurements, mean values of IMT of right CCA were 0.6396 mm and 0.6356 mm; of the left CCA were 0.6662 mm and 0.6575 mm, respectively. The interobserver variability of measurements revealed the mean IMT as 0.6071 mm and 0.6048 mm for the right, 0.6216 mm and 0.6227 mm for the left CCA. Manual measurements of both investigators were found to be higher than the automatic measurements and the differences were statistically significant. Interobserver correlation of manual measurements was between 0.80-0.88 and of the automated measurements was between 0.93-0.98. CONCLUSION: Manual measurements reveal higher values than the automated measurements of IMT. The interobserver correlation of automated measurements is higher than manual measurements. The use of dedicated software may be proposed to reduce the measurement errors.

Adult↗

[Design of software and hardware complex of automated systems for the management of the State Sanitary and Epidemiological Surveillance].

A new information system (IS) - the software and hardware complex for controlling the state sanitary-and-epidemiological inspection (SSEI) was created. The system represents the aggregate of automated working places of RF MD chief state sanitary physician arid specialists from the department of state sanitary-and-epidemiological inspection of the Main Military Medical Headquarters. They interact through communications with working places of specialists from SSEI Main Center, chief state sanitary physicians from the Armed Forces, military districts (fleets) and RFAF CSSEI. The special software provides automation of the following technological processes: operative sanitary-and epidemiological and epidemiological monitoring; the epidemiological analysis of infectious diseases; the evaluation of quality and efficiency of sanitary-and epidemiological work. At present the complex works in the regime of experimental exploitation when the adjustment of communications and special software is performed.

Computer Systems↗

Software process improvement for the medical industry.

This chapter describes a software process improvement framework, structured to ensure regulatory compliance for the software developed in medical devices. Software is becoming an increasingly important aspect of medical devices and medical device regulation. Medical devices can only be marketed if compliance and approval from the appropriate regulatory bodies of the Food and Drug Administration (US requirement), and the European Commission under its Medical Device Directives (CE marking requirement) is achieved.

Device Approval↗

[Design of a quantitative analysis software system for myocardial contrast echocardiography].

This article reports a quantitative analysis software system for myocardial contrast echocardiography (MCE). It can measure the signal intensity of grayscale images and power Doppler images, draw the time-intensity curves of variations on the intensity of microbubbles scattering in subendocardial layer and subepicardial layer with the pulsing intervals, and estimate the hemodynamic parameters by nonlinear regression analysis. This system has been applied to a study on 20 healthy volunteers, and the results suggest that the software has the capacity for bringing the quantitative analysis of MCE to success. The MCE software system conforms to the DICOM standard and can be integrated into PACS.

Adult↗

Combination of physical exercise and adenosine improves accuracy of automatic calculation of stress LVEF in gated SPECT using QGS software.

BACKGROUND: Combining exercise and adenosine during the stress phase of myocardial perfusion imaging (MPI) is known to reduce adverse effects and improve image quality. The aim of this study was to assess whether it can also improve the automatic calculation of left ventricular ejection fraction (LVEF) by QGS software package, during the stress phase of Gated SPECT. MATERIAL AND METHODS: One hundred patients who had stress Gated SPECT were retrospectively included in this study. Gated data of those who had adenosine only (50 patients=group A) was compared with those obtained in another group of 50 patients who had added bicycle exercise (Group B). All had identical image acquisition protocol using (99m)Tc-tetrofosmine. Clinical adverse effects, changes in blood pressure (BP), heart rate (HR), and ECG were monitored. Visual assessment of subdiaphragmatic uptake and accuracy of automatic regions of interest (ROI's) drawn by the software were noted. Regions of interest that involved sub-diaphragmatic uptake and resulting in low LVEF were manually adjusted to include the left ventricle only, and the frequency of manual adjustment was noted. RESULTS: No significant difference was noted in age, sex, baseline BP and HR between groups A and B. Adverse effects occurred less often in group B compared to group A (12% vs. 24%, p=0.118). Maximum HR and BP achieved during stress were significantly higher in group B compared to group A (p=0.025, p=0.001 respectively). The number of patients who had faulty ROI's and low LVEF, who needed manual adjustment of ROI's, were higher in group A compared to group B (16% vs. 6%, p=0.025). The values of LVEF showed significant improvement following manual adjustment of ROI's, increasing from a mean of 19.63+/-15.96 to 62.13+/-7.55 (p=0.0001) and from 17.33+/-9.5 to 49.67+/- 7.7 (p=0.0014) in groups A and B respectively. CONCLUSION: The addition of exercise to adenosine significantly improves the automatic calculation of LVEF by QGS software during Gated SPECT and reduces the need for manual adjustment.

Adenosine↗

Quantifying the disease impact of alcohol with ARDI software.

Alcohol-Related Disease Impact (ARDI) Software has been developed for the Centers for Disease Control (CDC) to allow States to calculate mortality, years of potential life lost (YPLL), direct health-care costs, indirect morbidity and mortality costs, and nonhealth-sector costs associated with alcohol use and misuse. The mortality related measures--mortality, YPLL, and indirect mortality costs--are computed for 35 diagnoses related to alcohol use and misuse. A review of clinical research studies and injury surveillance studies was conducted to produce estimates of the alcohol-attributable fraction (AAF) for each diagnosis. For these measures, age-specific and age-adjusted rates are also calculated. Health care costs, morbidity costs, and nonhealth-sector costs are prorated from national studies to the State or locality. This multiple-measure approach to quantifying a health problem is termed "disease impact estimation." National estimates of the disease impact of alcohol use and misuse have been produced using ARDI software and State-specific estimates are in preparation. Designed to CDC specifications, ARDI is completely menu-driven and operates within Lotus 1-2-3 software as a set of linked spreadsheets. ARDI adapts national epidemiologic and health economics methods for use by State and local health agencies. ARDI produces data on the health consequences of alcohol use and misuse for use by locally based policymakers, public health professionals, and researchers, while permitting comparison and compilation of these data across jurisdictions.

Alcohol Drinking↗

Surveying free and low-cost survey software.

Surveys are widely used to gather health information from a sample of individuals. This brief report reviews 14 free and low-cost software packages (< dollar 1,000) that can be used when conducting health surveys with a limited budget. Information available on the Internet or directly from the provider in response to inquiry was reviewed for key features used by health survey researchers. Many free or low-cost software options appropriate for questionnaire development are readily available. Questionnaire mode and complexity, data management and analytical needs, and computing environment are all important considerations in selecting survey software.

Costs and Cost Analysis↗

[Development of new software (Ver. 2.0) based on the Bayesian estimation utilized in the therapeutic drug monitoring of teicoplanin, a glycopeptide antibiotic].

We developed a new software (Ver. 2.0) based on the Bayesian estimation utilized in the therapeutic drug monitoring (TDM) of teicoplanin, a glycopeptide antibiotic, for the estimation of individual pharmacokinetic parameters. Individual pharmacokinetic parameters were calculated by a least squares methods, MULTI2 (BAYES), and a two-compartment model with population pharmacokinetic parameters in adult patients in Japan was adopted. The predicted teicoplanin concentrations in patients were similar to the observed concentrations, suggesting that the software predicts with acceptable precision. This new software is now available in clinical practice.

Adult↗

AuthorBase: a database of authoring systems software.

A working prototype database of authoring system software was developed as part of a study of authoring software conducted by the National Library of Medicine. The database and development issues ranging from the scope of the database to what information to document are described. The protype demonstrates that records of reasonable integrity can be derived from vendor supplied information as long as users understand the database is only an initial starting point in searching for authoring software and a resource for becoming generally familiar with the technology.

Authorship↗

[Computer-assisted design in removable partial dentures. Expert system and software for framework tracing].

Stelligraph, a software program for designing the removable partial denture offers many possibilities in computer assisted technology. The design can be realized on any particular case, based on three different concepts. This software program can also provide on individual, manual and personalized design this offening complete freedom in the conception. This software program is an expert system in removable partial denture by providing the general practitioner with a rational design as well as clinical guidance for oral rehabilitation.

Denture Design↗

Quantifying the disease impact of cigarette smoking with SAMMEC II software.

Smoking-Attributable Mortality, Morbidity, and Economic Costs Software, Release II (SAMMEC II) has been developed for the Office on Smoking and Health, Public Health Service, to permit rapid calculation of deaths, years of potential life lost, direct health-care costs, indirect mortality costs, and disability costs associated with cigarette smoking. For the mortality-related measures, age-specific and age-adjusted rates are also calculated. The pivotal epidemiologic measure in these calculations is the smoking-attributable fraction, and attributal risk measure. A multiple-measure approach (attributable mortality and economic costs) to quantifying a health problem is termed "disease impact estimation." Previously, national and State-specific estimates of smoking-attributable mortality and economic costs were calculated using SAMMEC software, the predecessor of SAMMEC II. SAMMEC II is completely menu-driven and operates within the Lotus 1-2-3 software as a set of linked spreadsheets. SAMMEC II adapts national epidemiologic methods for use by State and local health departments. Increased exposure of public health professionals to disease impact estimation techniques, as demonstrated by SAMMEC II, will lead to improvements in both methodology and the quality of smoking-related health data. The primary purpose of SAMMEC II, however, is to provide State or locality-specific data on the health consequences of smoking to policymakers and public health professionals in these jurisdictions.

Cost Allocation↗

[Convenient and useful computer software for the anesthesiologist].

Convenient and useful computer software for the anesthesiologist to draw figures for presentation, or to perform statistical analysis were presented. Each software is selected in the condition that it does not need special optional hardware, and processes the data quickly even with an old type computer, and also that even a computer beginner can easily operate it. The presented software are as follows: 1) Silhouette (drawing figures), 2) NEO (drawing figures), 3) Graph note (drawing figures), 4) Chart up science (drawing figures), 5) Z's word JG (making slide manuscripts) and 6) Biostat (doing statistical analysis).

Anesthesiology↗

Computer system and software of POSITOLOGICA II: a whole body positron emission tomograph.

Since a whole body PET-scanner POSITOLOGICA II was installed at the National Institute of Radiological Sciences (NIRS) in 1982, improvements of the computer system and developments of new software have been continuously made to correspond to clinical requirements. As the result, POSITOLOGICA II possesses one of the most powerful systems and sophisticated software in Japan. This report describes the present status of the computer system and software of POSITOLOGICA II. It also discusses problems which still exist and proposes a future computer system for the PET study.

Brain↗

Protein databases and software on BIONET.

BIONET provides databases, software, and networking/communications tools to over 2500 molecular biologists worldwide. Software for the analysis of nucleic acid and protein sequence data is provided by both IntelliGenetics and academic contributors. BIONET is currently implementing dedicated high speed servers for searching protein databases, as well as providing more flexible tools for protein structure recognition and prediction. In this review, protein databases and analysis software available on the BIONET resource are described, and progress in providing new tools for structure prediction, comparative sequence analysis, and pattern recognition using Artificial Intelligence (AI) techniques are summarized.

Amino Acid Sequence↗

Software review: Dioptimum.

UNLABELLED: BEST FEATURES: The software screens all preoperative measurements to detect those likely to be in error. This data screening function is based on statistical analysis of the distribution of eye measurements within the human population. If measurements are input that are far from the average value, the program will identify those cases with a message on the screen and a large warning sign. Nevertheless, the program will perform the requested lens power calculations. The program will also compare measurements between right and left eyes, if both are entered, and a test is performed on the asymmetry between the eyes. WORST FEATURES: The lack of a written owner's manual is probably the most glaring defect of the program, even though most of the important information is present on a disk. Only users familiar with running software programs will be able to easily obtain the data. The program can be installed on a hard disk only two times. For physicians with multiple offices or multiple computers that are not on-line, this is a significant handicap. HARDWARE REQUIREMENTS: Two floppy disk drives, 256K RAM and printer, DOS 3.0 or higher are required. One floppy drive plus a hard drive can also be used. The program will run a TTL monochrome or color monitor but the type of color monitor is not specified. LIST PRICE: $495 COPY PROTECTION: Yes USER SUPPORT: 800 number available EASE OF USE: Good ON SCREEN HELP: Yes CONSUMER VALUE: Very expensive PERFORMANCE: Excellent PUBLISHED BY: Storz Ophthalmics, Inc. 1365 Hamlet Avenue Clearwater, FL 34616 (818)-443-2606 or (800)-237-5906 A defective disk can be returned for replacement at no charge within 1 year of the date of purchase. Beyond that date, disks can be replaced at a cost of $10.00. In summary, this is a very well thought out software program for calculating and printing IOL powers using a second-generation lens implant power formula. With appropriate written documentation, the program will become extremely easy to use, even for novices. Because it is so simple to use, surgeons will continually update their personalized surgeon factors and patient data in order to provide patients with the best possible refractive results. A discussion of the use of the Holladay formula in comparison to other formulas is found in reference 2.

Humans↗