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Transcriptome analysis and related databases of Lactococcus lactis.

Several complete genome sequences of Lactococcus lactis and their annotations will become available in the near future, next to the already published genome sequence of L. lactis ssp. lactis IL 1403. This will allow intraspecies comparative genomics studies as well as functional genomics studies aimed at a better understanding of physiological processes and regulatory networks operating in lactococci. This paper describes the initial set-up of a DNA-microarray facility in our group, to enable transcriptome analysis of various Gram-positive bacteria, including a ssp. lactis and a ssp. cremoris strain of Lactococcus lactis. Moreover a global description will be given of the hardware and software requirements for such a set-up, highlighting the crucial integration of relevant bioinformatics tools and methods. This includes the development of MolGenIS, an information system for transcriptome data storage and retrieval, and LactococCye, a metabolic pathway/genome database of Lactococcus lactis.

Databases, Nucleic Acid↗

[Computer-assisted drug information].

Experience with a university hospital based drug information service (DIS) is reported. A total of 501 drug related questions were analyzed during two prospective evaluation periods of 13 and 14 months' duration respectively. Information was requested by physicians and pharmacists chiefly on practical aspects of drug treatment in individual patients (77%), such as drug choice, dosage adaptation, side effects and interactions. Inquiries on drug safety in pregnancy and lactation (8.8%), and questions on pharmaceutical properties (14.2%), including pharmacokinetics, were also frequent. Our experience indicates that a problem-oriented, comprehensive DIS necessitates close cooperation between physicians trained in clinical pharmacology and pharmacists within the same team. The use of electronic media greatly facilitates the collection of drug related information, data retrieval and storage. Drug information services can contribute to improved quality and safety of drug therapy.

Computers↗

Improving the record of patient assessment in the trauma room.

To facilitate clinical research at the Regional Trauma Unit at Sunnybrook Medical Centre in Toronto, it was decided to attempt to improve the quality and quantity of clinical patient information obtained at initial assessment in the Trauma Room. Standardized patient forms were introduced to replace the narrative record, including forms for the Trauma Team Leader, Anesthesia, General Surgery, Neurosurgery, Orthopedic Surgery, and Plastic Surgery. These forms were evaluated in this study which compared 100 charts generated before introduction of the forms to 100 charts generated following the implementation of the forms, with respect to certain items of patient demography and clinical condition. There was a statistically significant improvement in amount of information collected and in a format which facilitates data storage and retrieval. This, in turn, establishes an excellent standardized database for clinical trials in trauma care.

Emergency Medical Service Communication Systems↗

Microcomputer-generated reminders. Improving the compliance of primary care physicians with mammography screening guidelines.

Recent studies have documented that physician compliance with recommended periodic health screening improves with reminders to physicians. These reminders, however, are often costly to maintain and modify. This study investigates the influence of a microcomputer tickler system on the ordering of mammograms. All women (N = 1262) aged 40 years and older who made visits to an outpatient office during a 6-month period were randomly assigned to one of two groups. For the experimental group, the date of the last mammogram ordered and recorded in the clinical database was printed on the encounter form generated for each patient visit. No information regarding previous mammograms was printed for patients in the control group. Women in the experimental group were more likely to have a mammogram ordered during the study period (19% compared with 12%, P = .001) and, as a result, were more likely to be in compliance with mammography guidelines at the study's completion (27% compared with 21%, P = .011). Microcomputerized data storage and retrieval systems may help increase physicians' attention to preventive health screening recommendations.

Adult↗

Cognitive performance deficits in a simulated climb of Mount Everest: Operation Everest II.

Cognitive function at simulated altitude was investigated in a repeated-measures, within-subject study of performance by seven volunteers in a hypobaric chamber, in which atmospheric pressure was systematically lowered over a period of 40 d to finally reach a pressure equivalent to 8,845 m, the approximate height of Mount Everest. The portable cognitive test battery used, Automated Performance Test System (APTS), was specifically designed for field research under adverse environmental conditions as evidenced by compact computer design; automated test administrations, data storage, and retrieval; psychometric properties of stability and reliability; and factorial richness. Significant impairments of cognitive function were seen for three of the five tests in the battery; on two tests, grammatical reasoning and pattern comparison, every subject showed a substantial decrement. The results are discussed in terms of the impact of altitude on specific aspects of cognitive function and the importance of having sensitive and reliable instruments to monitor such effects.

Adult↗

A surgical pathology reporting and encoding system using industry-standard hardware and software.

I describe an efficient, inexpensive, industry-standard computer system that is designed for word processing of surgical pathology reports as well as encoding in Systematized Nomenclature of Medicine (SNOMED) and data storage. This system is capable of maintaining a large database of patient information with coded diagnoses. It is designed to be utilized with readily available stock computer hardware and software without significant customization or any additional programming. The hardware is easily purchased from and can be maintained by a retail, business-oriented computer store. The system described incorporates WordPerfect for word processing and the CAP/SNOMED system for diagnosis encoding and data storage and retrieval.

Humans↗

Computer-assisted learning and evaluation in medicine.

The use of the computer in medical education has been in evolutionary development since the early 1960s; its adoption, however, has been less widespread than the promise of the medium should warrant. Computer-assisted instruction enhances learning, allowing the student the discretion of content, time, place, and pace of instruction. Information conveyed can take several forms, some better suited to undergraduate medical education, others more applicable to graduate and continuing education. The use of the computer in certification and licensure could, within a decade, transform the way competence is assessed. Its greatest promise, however, may lie in providing pertinent information at the time when, and in the place where, patient care takes place. New developments in data storage and retrieval forecast applications that could not have been imagined even a year or two ago.

Computer Simulation↗

Analysis of dietary data; an interactive computer method for storage and retrieval.

The authors briefly review some problems encountered in collecting and interpreting dietary data and in analyzing them by hand and by computer methods. The use of computers, meant to speed processing, has often delayed processing or merely replaced computation time with coding time. The authors describe a simplified nutrient data base and an interactive retrieval method, Quick Input of Food, which has been developed for direct use by nutritionists with their clients.

Computers↗

Interactive computer supported tumor registry in the state of Rhode Island.

A new interactive computerized tumor registry has been established for the state of Rhode Island. The registry is implemented with new data base software which features a pagination scheme with rapid retrieval of non-coded variable data. The types of data stored are discussed as well as the computer system and methods of data entry storage and retrieval.

Computers↗

Methodological considerations: using large data sets.

Studies in the field of outcomes research often use very large data sets. Before data collection, specific issues related to data storage, data collection, and data retrieval should receive careful consideration. New technologies have made the process more cost-effective, efficient, and under the direct control of the researcher.

Data Collection↗

A computerized system for recording data in gastrointestinal endoscopy.

Over the past five years, the authors have developed a computerized system to record and store all the data pertaining to an endoscopic examination of the upper digestive tract. The system was designed to permit the easy storage and retrieval of data by personnel who lack computer skills and who may only have limited typing ability. The system allows for the storage and rapid retrieval of patients' individual records, as well as correction and/or deletion of these records. The system prints out copies of preliminary endoscopic findings and produces a final copy which contains histological and cytological findings. The program utilizes a standardized nomenclature, which however permits the introduction of each user's code in 16 areas of classification. It is possible to analyze statistically and correlate the stored data, permitting easy use for clinical studies. The uniformity of the methods for storage of and access to patients' records and data, along with the support of a central computer, allows multi-centre studies in the field of epidemiology. As of January 1991 30 endoscopic centres in Portugal have been equipped with this system. Overall the experience in these centres has been positive, with excellent or good participation in 76.7% of centres.

Endoscopy, Gastrointestinal↗

[The use of an integrable mobile full text processing systems (author's transl)].

A mobile full text processing system is reported which is independent of a computer, yet can be completely integrated into a data processing system and is purely a storage and retrieval system for data files and data banks which, with relatively little activity ratio of the individual items of information stored, still have an unusually large, widely ramified indexing depth. Acquisition of material, storage and retrieval of information are so simplified in favor of the user, that they can be carried out without specially qualified data processing personnel, but by normal office staff and one's own colleagues after a simple short instruction. The favorable cost makes the system an alternative worth considering in many cases, because fully automatic documentation or system concepts which need digital storage of large quantities of text demand so much intellectual expense and electronic storage capacity, that they are already prohibitive on grounds of cost alone.

Costs and Cost Analysis↗

On-line storage, retrieval, and evaluation of long-term electrocardiographic monitoring data.

A set of on-line computer programs has been designed and implemented for the acquisition and long-term storage, retrieval, and evaluation of Holter monitoring data. The physician interpreting Holter tapes enters his findings in the computer system using an on-line remote terminal located in the heart station. The programs are available practically around the clock and allow reviewing of individual cases, preparation of printed reports, and fast evaluation of the presence or absence of a number of common findings in the entire data base. Approximately 800 cases have been entered since the initiation of this project in early 1977.

Electrocardiography↗

Microcomputer application: an image database system for electron microscopy.

An electron microscopist in a small electron microscopy laboratory that processes 200 cases per year can generate at least 2000 electron micrographs within this time period. These electron micrographs are stored in filing cabinets, which slowly encroach on existing laboratory space. Related image data are often located in separate filing systems. This type of storage system is inefficient for rapid retrieval of sets of electron micrographs for research, teaching, or retrospective review of patient material. An electron microscopy image base, which is implemented on a microcomputer, can provide flexible and simultaneous access to both digitized electron micrographs and their relevant textual data. In addition to the advantage of more efficient retrieval, electronic storage of textual data and digitized electron micrographs also offers the advantage of decreased storage space for this type of data. Implementation of the initial version of the electron microscopy image base demonstrated that future versions must provide improved resolution of the digitized electron micrograph and sufficient electronic mass storage to support such a large image base. Ongoing developments in database technology and mass storage make it worthwhile to pursue additional refinements of the electron microscopy image base.

Database Management Systems↗

Automated scanning and digitizing of roentgenographs for documentation and research.

A comprehensive system has been developed for analyzing and reporting the results of total hip arthroplasty. The personal-computer-based system links patient demographic data with digital storage, retrieval, and analysis of roentgenographs. The system consists of a roentgenograph scanner for converting sheet film to digital data, an optical mark reader for patient data input, an archiving system with optical storage, and a physician display station for preoperative planning and postoperative evaluation. Once a roentgenograph has been digitized and stored, the image can be retrieved and manipulated in a manner not possible with the original sheet film. A selected roentgenograph can be brought to full or enlarged scale, enhanced, and overlaid with templates for preoperative planning or for postoperative measurement of changes. In addition, an intelligent database system has been developed for linking patient demographic information with the roentgenographic data. The database system employs uniform criteria and terminology and allows the retrospective study and statistical analysis of comparable cases. Three machine-readable code sheets are used: Form A, Replacement of the Hip; Form B, Hip Prosthesis Reoperation; and Form C, Follow-up. Forms A and B contain information concerning anamnesis, diagnosis, treatment, postoperative course, recovery, and discharge of the patient from the hospital. Form C provides information on physical examination, pain, mobility of the hip, walking ability, and evaluation of the results by the surgeon as well as the patient.

Computer Systems↗