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At least 163 records · Page 9Linked to original sources
PubMed2002

The USU medical PDA initiative: the PDA as an educational tool.

A medical personal digital assistant (PDA) initiative for healthcare students began in 2000 at the Uniformed Services University of the Health Sciences (USU). The University issued PDAs to Graduate School of Nursing (GSN) and School of Medicine (SOM) students. These devices were used to provide clinical reference material to the students, to facilitate clinical experience log collection, and the normal organizer functions of a PDA. Both medical and graduate nursing students were surveyed both before and during clinical training to determine the perceived usefulness of the PDA. A quantitative approach was utilized to emphasize the measurable variables.

Attitude to Computers↗
PubMed1998

Impact of the diagnostic methods on the therapeutic strategies.

Over the last 25 years the diagnostic approaches and therapeutic strategies of breast cancer have dramatically changed. The relationship between diagnosis and therapy has gradually become more complex due to the ever more sophisticated diagnostic tools (mammographic screening, digital mammography, magnetic resonance, SPECT scan and FDG-PET), which have improved resolution limits and accuracy, and also due to the different therapeutic planning applied to breast cancer in these years (conservative surgery, neo-adjuvant chemotherapy, axillary dissection or not). Thus, in this paper, we have briefly analyzed the many open questions in breast cancer management and the clinical challenges of present diagnostic tools in relation to pre-, peri- and postoperative phases, and to therapeutic strategies in general. The main goal of mammographic screening is to detect early invasive cancers and to treat them at the first useful moment. However, at which age should one begin screening, and what is the impact on overall survival, the cost-effectiveness, and, most of all, the best operative approach to suspect lesions? Can digital mammography give a better quality of imaging with respect to conventional mammography? Does unexpected multicentricity and/or multifocality, which is sometimes showed by magnetic resonance, have any clinical relevance? Is this technique really better than traditional methods for the identification of local recurrence? Is scintimammography able to improve the low diagnostic accuracy of mammography on non-palpable breast lesions? Moreover, at present, the need for axillary dissection and its therapeutic and staging value is deeply debated: however, clinical detection of axillary metastases is not a reliable diagnostic tool and there are no conventional radiologic techniques to be used: recently nuclear medicine imaging has provided various approaches, such as SPECT scan with different tracers, FDG-PET, or lymphoscintigraphy with gamma probe sentinel biopsy: there are not only methodologic but also phylosophic differences in using these techniques. Neo-adjuvant chemotherapy has allowed a dramatic reduction of primary breast cancer with a replanning of the surgical approach to large breast tumours but, at the same time, has posed new questions such as the adequacy of diagnostic pre- and perioperative revaluation. Finally, does postoperative follow-up take advantage of intensive diagnostic programs and are there therapeutic margins which would improve survival of patients with metastatic disease? This paper is an attempt to analyze the answers given in the literature. Nevertheless, at present, this matter is globally in progress and a scientific debate will provide, in the near future, a new promising scenario for breast cancer management.

Age Factors↗
PubMed2000

Wound measurement: the comparative reliability of direct versus photographic tracings analyzed by planimetry versus digitizing techniques.

OBJECTIVE: To investigate two methods of wound measurement (planimetry and digitizing) performed on two routinely used techniques of clinical wound assessment, tracings taken directly from a patient's wound (raw tracing) and from photographs of the wound (photographic tracing). DESIGN: We examined the level of repeatability and thus reliability of these methods, and determined if absolute measured wound size differed between the combinations of method and assessment procedures. PATIENTS: Seven patients (4 women, 3 men; mean age +/- standard error of the mean = 63.1+/-5.0yrs) with a total of 11 wounds. SETTING: Patients attended a podiatry outpatient department on two separate days for raw and photographic tracing of their wounds. For both of these trace types, a series of repeated recordings were conducted by a single investigator using planimetry and digitizing measurement methods. MAIN OUTCOME MEASURE: Independent statistical analyses (analysis of variance, p < .05) were conducted on logged coefficients of variation and logged means data to investigate for repeatability and for size differences, respectively. RESULTS: Planimetry produced a significantly larger degree of variability (thus less repeatability) than digitizing (p = .02) and also produced smaller readings (p = .00001). Averaging over methods also indicated that photographic tracings produced smaller readings than raw tracings (p = .019). CONCLUSION: For the wound sizes and shapes examined, tracings taken directly from the patients were found to be an inexpensive clinical and research assessment tool on which digitizing was conducted with a higher level of repeatability than planimetry. Further research is needed to determine if the current findings apply to a wider population within wound management clinics.

Female↗
PubMed2001

Comparing the similarity of time-series gene expression using signal processing metrics.

Many algorithms have been used to cluster genes measured by microarray across a time series. Instead of clustering, our goal was to compare all pairs of genes to determine whether there was evidence of a phase shift between them. We describe a technique where gene expression is treated as a discrete time-invariant signal, allowing the use of digital signal-processing tools, including power spectral density, coherence, and transfer gain and phase shift. We used these on a public RNA expression set of 2467 genes measured every 7 min for 119 min and found 18 putative associations. Two of these were known in the biomedical literature and may have been missed using correlation coefficients. Digital signal processing tools can be embedded and enhance existing clustering algorithms.

Algorithms↗
PubMed1999

Digital radiography in dentistry: what it should do for you.

Digital radiology will become an important part of dental practice. Manufacturers should develop more sophisticated tools, including software for digital subtraction; image processing routines for the diagnosis of caries, periodontitis and periapical disease; tools for three-dimensional viewing of the teeth and supporting structures; and analysis of bone trabecular pattern for early detection of systemic disease. Hardware improvements should include increased dynamic range and sensitivity to radiation, and improved resolution. Sensors should be made the size of film, and components should be interchangeable across manufacturers. The true opportunity offered by digital imaging, computer-aided diagnosis, should continue to develop with particular attention to development of tools that add value for solving diagnostic problems and ease of use for the dentist and patient.

Dental Equipment↗
PubMed1998

Creating and curating a pediatric radiology digital library to make the internet a useful reference tool for the radiologist.

BACKGROUND: To practice pediatric radiology optimally, radiologists need convenient access to organized and authoritative pediatric radiology information. The Internet has the potential for offering such convenient access, but the majority of information on it is poorly organized and of questionable authority. OBJECTIVE: The goal of this project was to create and curate a pediatric radiology digital library that will make the Internet a useful reference tool for the radiologist at the point-of-care. MATERIALS AND METHODS: A pediatric radiology digital library containing organized and authoritative pediatric radiology information from the Internet was created and has three components : (1) PediatricRadiology.com (http://pediatricradiology.com)--a catalog of pediatric radiology Web sites; (2) The MetaTextbook of Pediatric Radiology (http://www. vh.org/Providers/TeachingFiles/MetatextbookPedRad/MetaTBP edRad.html)--a catalog of pediatric radiology teaching file cases on the Internet; and (3) Paediapedia (http://www.vh. org/Providers/TeachingFiles/PAP/PAPHome.html)--an imaging encyclopedia of pediatric disease. The pediatric radiology digital library is curated regularly. RESULTS: Over 7 months, 223,689 pages of information were read and 26,972 images were viewed in the pediatric radiology digital library by 69,866 individual users, with 20% of the users from outside the United States. CONCLUSION: Creating a pediatric radiology digital library that identifies and organizes authoritative pediatric radiology information and makes it conveniently available can allow radiologists to use the Internet productively as a reference tool.

Child↗
PubMed2003

A navigated mechatronic system with haptic features to assist in surgical interventions.

OBJECTIVE: In orthopaedic surgery, the development of new computer-based technologies such as navigation systems and robotics will facilitate more precise, reproducible results in surgical interventions. There are already commercial systems available for clinical use, though these still have some limitations and drawbacks. This paper presents an alternative approach to a universal modular surgical assistant system for supporting less or minimally invasive surgery. MATERIALS AND METHODS: The position of a mechatronic arm, which is part of the system, is controlled by a navigation system so that small patient movements are automatically detected and compensated for in real time. Thus, the optimal tool position can be constantly maintained without the need for rigid bone or patient fixation. Furthermore, a force control mode of the mechatronic assistant system, based on a force-torque sensor, not only increases safety during surgical interventions but also facilitates hand-driven direct positioning of the arm. RESULTS: A prototype has been successfully tested in clinical applications at the Orthopadische Universitätsklinik Frankfurt. For the first time worldwide, implantation of the cup prosthesis in total hip replacement surgery has been carried out with the assistance of a mechatronic arm. According to measurements by the digitizing system, operating tool angle deviation remained below 0.5 degrees, relative to the preoperative planning. CONCLUSION: The presented approach to a new kind of surgical mechatronic assistance system supports the surgeon as needed by optimal positioning of the surgical instruments. Due to its modular design, it is applicable to a wide range of tasks in surgical interventions, e.g., endoscope guidance, bone preparation, etc.

Arthroplasty, Replacement, Hip↗
PubMed2003

Automated reconstruction of three-dimensional neuronal morphology from laser scanning microscopy images.

Experimental and theoretical studies demonstrate that both global dendritic branching topology and fine spine geometry are crucial determinants of neuronal function, its plasticity and pathology. Importantly, simulation studies indicate that the interaction between local and global morphologic properties is pivotal in determining dendritic information processing and the induction of synapse-specific plasticity. The ability to reconstruct and quantify dendritic processes at high resolution is therefore an essential prerequisite to understanding the structural determinants of neuronal function. Existing methods of digitizing 3D neuronal structure use interactive manual computer tracing from 2D microscopy images. This method is time-consuming, subjective and lacks precision. In particular, fine details of dendritic varicosities, continuous dendritic taper, and spine morphology cannot be captured by these systems. We describe a technique for automated reconstruction of 3D neuronal morphology from multiple stacks of tiled confocal and multiphoton laser scanning microscopy (CLSM and MPLSM) images. The system is capable of representing both global and local structural variations, including gross dendritic branching topology, dendritic varicosities, and fine spine morphology with sufficient resolution for accurate 3D morphometric analyses and realistic biophysical compartment modeling. Our system provides a much needed tool for automated digitization and reconstruction of 3D neuronal morphology that reliably captures detail on spatial scales spanning several orders of magnitude, that avoids the subjective errors that arise during manual tracing with existing digitization systems, and that runs on a standard desktop workstation.

Animals↗
PubMed1999

Anatomical information in radiation treatment planning.

We report on experience and insights gained from prototyping, for clinical radiation oncologists, a new access tool for the University of Washington Digital Anatomist information resources. This access tool is designed to integrate with a radiation therapy planning (RTP) system in use in a clinical setting. We hypothesize that the needs of practitioners in a clinical setting are different from the needs of students, the original targeted users of the Digital Anatomist system, but that a common knowledge resource can serve both. Our prototype was designed to help define those differences and study the feasibility of a full anatomic reference system that will support both clinical radiation therapy and all the existing educational applications.

Anatomy, Artistic↗
PubMed2026

New Evidence in Heart Failure: 2026 Update.

Heart failure (HF) remains a major cause of morbidity, mortality, impaired quality of life and healthcare expenditure worldwide. The global burden of HF continues to increase due to population aging, improved survival, and the growing prevalence of cardiovascular, renal, and metabolic comorbidities. Simultaneously, the pace of scientific progress in HF has accelerated considerably. Recent advances have refined our understanding of HF epidemiology, prognosis, and disease trajectories, including emerging concepts of HF improvement, remission, and recovery. The Second Universal Definition of HF has also updated the classification framework, moving beyond the traditional ejection fraction-based categories. HF is now broadly classified into two major phenotypes: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Novel mechanistic insights highlight the role of inflammation, immune activation, metabolic dysfunction, mitochondrial biology, and multisystem interactions in HF progression. There has also been significant progress in the characterization and management of major comorbidities, including chronic kidney disease (CKD), diabetes, obesity, atrial fibrillation (AF), pulmonary hypertension, frailty, malnutrition, and cancer. Diagnostic innovations include novel biomarkers, multi-omics technologies, artificial intelligence-based approaches, advanced imaging techniques, congestion assessment tools, and emerging digital health solutions. Important advances have occurred in specific HF aetiologies, including cardiomyopathies, cardiac amyloidosis (CA), myocarditis, arrhythmia-induced cardiomyopathy (AiCM), and Chagas cardiomyopathy. Therapeutic developments continue to reshape HF management across the spectrum of left ventricular ejection fraction. Recent evidence has focused on optimization of guideline-directed medical therapy in HFrEF, expansion of evidence-based therapies in HFpEF, and growing roles for sodium-glucose cotransporter-2 inhibitors, finerenone, incretin-based therapies, and transcatheter valve interventions. Collectively, these advances support the transition from a predominantly phenotype-based approach towards a more personalized and biologically informed model of HF care, with the potential to further improve outcomes across the entire HF spectrum.

Journal Article↗
PubMedDate not supplied

User interaction with scatterplots on small screens--A comparative evaluation of geometric-semantic zoom and fisheye distortion.

Existing information-visualization techniques that target small screens are usually limited to exploring a few hundred items. In this article we present a scatterplot tool for Personal Digital Assistants that allows the handling of many thousands of items. The application's scalability is achieved by incorporating two alternative interaction techniques: a geometric-semantic zoom that provides smooth transition between overview and detail, and a fisheye distortion that displays the focus and context regions of the scatterplot in a single view. A user study with 24 participants was conducted to compare the usability and efficiency of both techniques when searching a book database containing 7500 items. The study was run on a pen-driven Wacom board simulating a PDA interface. While the results showed no significant difference in task-completion times, a clear majority of 20 users preferred the fisheye view over the zoom interaction. In addition, other dependent variables such as user satisfaction and subjective rating of orientation and navigation support revealed a preference for the fisheye distortion. These findings partly contradict related research and indicate that, when using a small screen, users place higher value on the ability to preserve navigational context than they do on the ease of use of a simplistic, metaphor-based interaction style.

Journal Article↗
PubMed1999

An artificial neural net and error backpropagation to reconstruct single photon emission computerized tomography data.

At present, algorithms used in nuclear medicine to reconstruct single photon emission computerized tomography (SPECT) data are usually based on one of two principles: filtered backprojection and iterative methods. In this paper a different algorithm, applying an artificial neural network (multilayer perception) and error backpropagation as training method are used to reconstruct transaxial slices from SPECT data. The algorithm was implemented on an Elscint XPERT workstation (i486, 50 MHz), used as a routine digital image processing tool in our departments. Reconstruction time for a 64 x 64 matrix is approximately 45 s/transaxial slice. The algorithm has been validated by a mathematical model and tested on heart and Jaszczak phantoms. Phantom studies and very first clinical results ((111)In octreotide SPECT, 99mTc MDP bone SPECT) show in comparison with filtered backprojection an enhancement in image quality.

Algorithms↗
PubMed2004

Assessment of ocular irritation by image processed quantification of cell injury in human corneal cell cultures and in corneal constructs.

Currently, there are no accepted alternative tests for the replacement of animals in ocular irritation testing. This study focused on the quantification of cellular viability as a measure of toxic events in immortalised human corneal cell cultures and a three-dimensional corneal construct. Simultaneous vital dye staining by calcein AM and ethidium homodimer-1 was used to provide "live" and "dead" probes, respectively. For further quantification, we have developed image processing tools to evaluate digital images obtained from confocal fluorescence scanning microscopy measurements. Based on the finding that ocular irritation can be related to the extent of cell injury at the various cell layers of the cornea, we extended our studies from corneal cell cultures to an in vitro human corneal equivalent system comprising epithelial, stromal keratocyte and endothelial layers. Our results showed that the microscopic measurement of cellular injury by using either cell cultures or in vitro corneal constructs, combined with image processed quantification, can provide insight into the extent of the toxic effects.

Animal Testing Alternatives↗
PubMed2003

NeuroNames 2002.

NeuroNames is a nomenclature designed as a tool for indexing digital databases of neuroscientific information. It can be used, for example, as the entry point to a digital dictionary of neuroanatomy, to a brain atlas, or to a database of information referenced to specific brain structures. The user can query with terms from many different nomenclatures. One can create a neuroanatomic ontology from NeuroNames by relating an appropriate subset of terms to a conceptual model represented by structures illustrated in a brain atlas. At the conceptual core of NeuroNames are primary structures, the elementary units of the brain in the spatial domain. Each primary structure is associated with a set of synonyms that represent the structure in the symbolic domain. One of the synonyms is designated the default name for use in verbal definitions of other structures. A unique abbreviation based on the default name is provided for labeling images. Neuroscientists classify structures in different contexts reflecting different attributes of interest. Thus, the name of a given structure can appear in any number of hierarchical contexts. In NeuroNames all primary structures are now represented in at least two hierarchies. The first is a nine-level "Brain Hierarchy," in which volumetric structures are grouped by proximity to form successively larger units that represent the brain at different levels of dissection. Secondly, primary structures are categorized in a three-level "spatial attribute hierarchy" used to color- code them for visual display. Grouped structures in the nine-level volumetric hierarchy are designated superstructures, each of which has synonyms, a default term, and an abbreviation. All names of structures not in the hierarchy are designated ancillary terms and are defined in words using the default names of hierarchy structures. With NeuroNames as entry point, we have developed BrainInfo (http://braininfo.rprc.washington.edu), a website that allows searchers to proceed intuitively in a few steps to descriptions and images of specific structures. Currently NeuroNames resides in a Microsoft ACCESS database and includes some 12,200 terms in seven languages.

Abstracting and Indexing↗
PubMed2004

[When and how is medical teleconsultation to doctors practising in remote areas of developing countries convenient and reliable? About eight clinical cases].

A poorly equipped internal medicine doctor (IMD), practising in remote areas of developing countries, can be assisted with expertise teleconsultations by using the common analogical telephone lines. By that way, the clinical cases he challenges became multidisciplinary and the success of the treatment enhanced. Eight cases are reported as examples. The expertise is made up by eight remote-access experts on different medical fields. The effectiveness of the support of the consultants is compared one to the other. In laboratory, dermatology and, partly, cyto-pathology fields the teleconsultations are reliable and not time-consuming, for the key tool is the digital picture sent by e-mailing. In cardiology (heart ultrasound scan) and radiology fields both effectiveness and benefit-cost ratio are disputable. Heart ultrasound scan is a dynamic test and filming is needed to provide the consultant with good records. In radiology field, the upper digestive tract X-ray scan is usually carried out with few shots, due to the unsustainable charges on the patient. That matter impairs the consultant's effectiveness to support. Although the black-outs of the transmission were common throughout IMD-consultant videoconferences, the physical examination of the patient, performed by the IMC under consultant's direct supervision, is highly supportive both in neurology and paediatric fields. The physiotherapist's show of physical rehabilitation exercises by videoconference is highly supportive as well.

Adolescent↗
PubMed2004

Serial analysis of gene expression (SAGE): application in cancer research.

Serial analysis of gene expression (SAGE) is a powerful tool that allows digital analysis of overall gene expression patterns. SAGE provides quantitative and comprehensive expression profiling in a given cell population. Because SAGE does not require a preexisting clone, it can be used to identify and quantitate new as well as known genes. It works by isolating short fragments of genetic information from the genes expressed in the cell being studied. These short sequences, called SAGE tags, are linked together for efficient sequencing. SAGE is particularly well suited for organisms whose genome is not completely sequenced, because it does not require a hybridization probe for each transcript and allows new genes to be discovered. New modifications of SAGE now permit the analysis of gene expression in cell sub-populations or micro-anatomic structures, providing access to unexplored transcriptomes of normal and disease biology. Data derived using the SAGE technology have been used to identify tumor markers for a variety of cancers, including gastrointestinal cancer, lung and thyroid cancer, breast and ovarian cancer, neuroblastoma and glioblastoma, prostate cancer, and renal cell carcinoma. In this review we present an outline of the method and updated information on the applications of SAGE technology to various cancers.

Biomedical Research↗
PubMed1989

[Fabrication of a 3-dimensional plastic model with photopolymer from CT images].

A new type of the 3-dimensional model fabricating system was developed using a focused laser beam and liquid photopolymer. The system can easily fabricate solid models, without tools, directly from digital data received from medical CT scanners or CAD systems. Solid models are fabricated as follows. After a layer of liquid photopolymer is placed above the already solidified layers, a laser beam is scanned along horizontally sliced patterns on the liquid photopolymer. The parts where the light shone is solidified. And then the solidified layers agreed with the patterns are stacked. This process is repeated for each layer. This paper describes the fabrication of a smoothly natural solid model from an original CT image sequence which is taken with rough pitches. Interpolation between original neighboring sliced images which are composed of extracted contour data is performed by use of the third order spline curve. This method can be implemented using a rather small computer. This technique can play a major role in diagnosis procedure, personal prosthesis design, and surgical operation planning.

Humans↗