A growing number of hospitals have installed PACS (Picture Archiving and Communications Systems) in order to improve patient care and to facilitate improved efficiencies. While eliminating films is ...commonly one of the first goals in planning a successful PACS implementation, eliminating the manual handling of paperwork can also produce a substantial benefit. We describe the process utilized at Maine Medical Center (MMC) to achieve a substantial degree of freedom from paperwork. Some of the benefits were expected, but some unexpected benefits also revealed themselves during this process.
Background: During the 3rd year of medical school, clerkships provide essential clinical experiences. However, other aspects of patient care may be overlooked during this critical phase of medical ...education. Faced with the challenge of integrating "orphan" topics central to effective and compassionate medical practice, medical schools have begun to develop interclerkships or intersessions.
Description: The Dimensions of Clinical Medicine (DCM) interclerkship series at Creighton University included evidence-based medicine, sexuality in clinical medicine, palliative care, professionalism, cultural sensitivity/awareness, complementary and alternative medicine, bioterrorism, and clinical ethics. Each interclerkship comprises 2 half-day sessions conducted at the end of each clerkship rotation.
Evaluation: Students approved of the interclerkship format and valued the active learning strategies employed in the course. Many students felt the time allotted for each program was excessive. We describe educational issues and practical concerns that are central to an effective intersession program.
Conclusion: The interclerkship format is a viable approach for incorporating orphan topics into the clinical curriculum.
Most RIS and PACS systems include extensive auditing capabilities as part of their security model, but inspecting those audit logs to obtain useful information can be a daunting task. Manual analysis ...of audit trails, though cumbersome, is often resorted to because of the difficulty to construct queries to extract complex information from the audit logs. The approach proposed by the authors uses standard off-the-shelf multidimensional analysis software tools to assist the PACS/RIS administrator and/or security officer in analyzing those audit logs to identify and scrutinize suspicious events. Large amounts of data can be quickly reviewed and graphical analysis tools help explore system utilization. While additional efforts are required to fully satisfy the demands of the ever-increasing security and confidentiality pressures, multidimensional analysis tools are a practical step toward actually using the information that is already being captured in the systems' audit logs. In addition, once the work is performed to capture and manipulate the audit logs into a viable format for the multidimensional analysis tool, it is relatively easy to extend the system to incorporate other pertinent data, thereby enabling the ongoing analysis of other aspects of the department's workflow.
Cysteamine (β‐mercaptoethylamine, or MEA) is a thiol‐reducing agent and has anti‐HIV activity. Because of these properties, cysteamine was evaluated as a vaginal contraceptive and tested for its ...effects on sperm function and on other sexually transmitted microbes. Cysteamine was contraceptive in the rabbit. Conception was inhibited completely when sperm were pretreated with 500 μg/ml cysteamine and was inhibited by more than 60% when 7.5 mg cysteamine was applied vaginally as a suspension in 50% K‐Y Jelly. Cysteamine had multiple effects on spermatozoa. Both acrosin (EC 3.4.21.10) and hyaluronidase (EC 3.2.1.35) were reversibly inhibited by cysteamine. Calculated IC50 values were 370 μg/ml and 150 μg/ml for acrosin and hyaluronidase, respectively. Cysteamine behaved as a poor spermicide when activity was measured by the 30‐second Sander‐Cramer test. However, sperm motility was inhibited completely when cysteamine was preincubated for 10 minutes prior to motility evaluation, at concentrations as low as 50 μg/ml. The calcium bnophore A23187—induced human acro‐some reaction was inhibited by cysteamine (IC50 = 0.5 μg/ml). Neither herpes simplex virus nor Neisseria gonorrhoeae was affected by cysteamine at concentrations as high as 500 μg/ml and 100 μg/ml, respectively. Cysteamine appears to have no effect on normal vaginal flora (i.e., lactobacillus). These results, together with published data, strongly support the further development of cysteamine as a topical contraceptive anti‐HIV agent.
Using radionuclide angiocardiography, we studied cardiac function in 10 men with myotonic muscular dystrophy who had no cardiac symptoms and were less than 50 years of age, comparing resting and ...exercise performance of the heart. Nine of 10 patients had an abnormality of myocardial function. The interaction of exercise-induced cardiomyopathy with conduction system abnormalities may be important in sudden cardiac dysfunction in patients with myotonic dystrophy.
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