Learning physiology from cardiac surgery patients.

1998 ◽  
Vol 274 (6) ◽  
pp. S74
Author(s):  
S Nicol ◽  
C Narkowicz

A number of pressures have led to a very great reduction or complete abandonment of the use of animals in the teaching of physiology in most medical schools. Often animal experiments have been replaced by computer simulations, but a simulation is only as good as the model or algorithm on which it is based and can never contain the depth of information or unpredictability displayed by real animals or patients. We used a computer-based system to collect cardiovascular data from patients instrumented for cardiac surgery, allowing students to "replay" an operation. These recordings were annotated with notes, diagrams and video clips, and a student workbook was written. The resulting package contained a wealth of physiological data and was perceived by students to be very clinically relevant. The very wealth of information, however, tended to overwhelm students, and so a series of introductory Computer tutorials were written to provide students with the background necessary to cope with the clinical data.

2018 ◽  
Vol 227 (4) ◽  
pp. S48
Author(s):  
William Z. Chancellor ◽  
James H. Mehaffey ◽  
Robert B. Hawkins ◽  
Curtis G. Tribble ◽  
Leora T. Yarboro ◽  
...  

2018 ◽  
Author(s):  
Zhihui Zhu ◽  
Haibo Zhang ◽  
Yuehuan Li ◽  
Xu Meng ◽  
Yuqing Jiao ◽  
...  

BACKGROUND Medical care for the Chinese population has been focused on first-line treatment, but with little follow-up on treated patients. As an important part of clinical work, follow-up evaluations are of great significance for the long-term survival of patients and for clinical and scientific research. However, the overall follow-up rate of discharged patients after surgery has been low for many years because of the limitations of certain follow-up methods and the presence of objective, practical problems. OBJECTIVE This study aimed to construct a new two-way interactive telemedicine follow-up platform to improve the collection of clinical data after cardiac surgery and provide reliable and high-quality follow-up services. METHODS Computer and network technologies were employed in the context of “Internet +” to develop follow-up databases and software compatible with a mobile network. Postoperative follow-up quality data including the follow-up rate and important postoperative indices were used as standards to evaluate the new follow-up management model after cardiac surgery. RESULTS This system has been officially operated for more than 5 years. A total of 5347 patients undergoing cardiac surgery have been enrolled, and the total follow-up rate was 90.22%. In addition, 6349 echocardiographic images, 4717 electrocardiographic images, and 3504 chest radiographic images have been uploaded during follow-up assessments. The international standardized ratio was 20,696 person-times. CONCLUSIONS This new management follow-up platform can be used to effectively collect clinical data, provide technical support for academic research, extend medical services, and provide more help to patients. It is of great significance for managing patients after cardiac surgery.


2011 ◽  
pp. 1513-1520
Author(s):  
Luigi Proserpio ◽  
Massimo Magni ◽  
Bernardino Provera

Interview with Anthony Davidson, SuperAguri F1 GP Driver (autosport.com, March 2, 2007): Q: Can you actually learn anything from the [F1 videogame] though? AD: Absolutely. When I did the 2004 season, I really relied on having video data from the team and using the PlayStation games as well to learn the circuits. We always deal in corner numbers, we don’t use the proper corner names, so we have a little map in the car with the numbers. For you to visualize it beforehand is a help, because when they talk about a bump in turn three then you know what they are talking about before you have even walked the circuit or seen any onboard footage. You know roughly what the track looks like and when you get out there you smile because it is exactly what you were doing in your living room. And now the graphics have stepped up another level it is so much more realistic. F1 drivers can benefit from computer simulations, with a supplement of training before racing on a newly built circuit, with no consolidated knowledge. Managers (and students, too) can benefit from PC-based simulations that recreate complex business worlds as well. Books contain theories, along with a good number of examples. Computer-based business games can add dynamism and a temporal dimension to the standard managerial theories contained in books. Many researchers think that the potential of the computer as a learning tool is very high if we involve the user in a simulation process, instead of giving him a description of reality. This theory is confirmed by many field examples, as shown before by the Formula 1 pilot, who adopts a particular software in order to learn how to drive on a circuit that he has not tested directly. U.S. Marines play Quake and Unreal to simulate the mission in which they will be involved. Business games, finally, start to be adopted in managerial education as learning support tools. For example, EIS simulation has been developed at Insead Business School in order to simulate organizational change, while FirmReality has been developed at Bocconi University to study the integrated use of organizational capabilities to gain competitive advantage. Scientific and managerial literatures recognize the potential of these instruments for learning purposes (compatible with andragogical and collaborative learning theories), but cannot address their design and the integration within distance-learning practices. The current debate on computer simulations involves the research and the standardization of rules for the project phases, in order to take advantage of the potential attributed to this tool, and enhance the compatibility between managers/students and this form of learning.


Author(s):  
Fatemeh Hosseinkhah ◽  
Hassan Ashktorab ◽  
Ranjit Veen ◽  
M. Mehdi Owrang O.

Modern electronic health records are designed to capture and render vast quantities of clinical data during the health care process. Technological advancements in the form of computer-based patient records software and personal computer hardware are making the collection of and access to health care data more manageable. However, few tools exist to evaluate and analyze this clinical data after it has been captured and stored. Evaluation of stored clinical data may lead to discovery of trends and patterns hidden within the data that could significantly enhance our understanding of disease progression and management. A common goal of the medical data mining is the detection of some kind of correlation, for example, between genetic features and phenotypes or between medical treatment and reaction of patients (Abidi & Goh, 1998; Li et al., 2005). The characteristics of clinical data, including issues of data availability and complex representation models, can make data mining applications challenging.


2011 ◽  
Vol 39 (2) ◽  
pp. 191-201 ◽  
Author(s):  
V. A. Pellegrino ◽  
Y. Mudaliar ◽  
M. Gopalakrishnan ◽  
M. D. Horton ◽  
C. J. Killick ◽  
...  

2009 ◽  
Vol 29 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Magda Galach ◽  
Andrzej Werynski ◽  
Jacek Waniewski ◽  
Philippe Freida ◽  
Bengt Lindholm

Background Controlling extracellular volume and plasma sodium concentration are two crucial objectives of dialysis therapy, as inadequate sodium and fluid removal by dialysis may result in extracellular volume overload, hypertension, and increased cardiovascular morbidity and mortality in end-stage renal disease patients. A new concept to enhance sodium and fluid removal during peritoneal dialysis (PD) is the use of dialysis solutions with two different osmotic agents. Aim To investigate and compare, with the help of mathematical modeling and computer simulations, fluid and solute transport during PD with conventional dialysis fluids (3.86% glucose and 7.5% icodextrin; both with standard sodium concentration) and a new combination fluid with both icodextrin and glucose (CIG; 2.6% glucose/6.8% icodextrin; low sodium concentration). In particular, this paper is devoted to improving mathematical modeling based on critical appraisal of the ability of the original three-pore model to reproduce clinical data and check its validity across different types of osmotic agents. Methods Theoretical investigations of possible causes of the improved fluid and sodium removal during PD with the combination solution (CIG) were carried out using the three-pore model. The results of computer simulations were compared with clinical data from dwell studies in 7 PD patients. To fit the model to the low net ultrafiltration (366 ± 234 mL) obtained after a 4-hour dwell with 3.86% glucose, some of the original parameters proposed in the three-pore model (Rippe & Levin. Kidney Int 2000; 57:2546-56) had to be modified. In particular, the aquaporin-mediated fractional contribution to hydraulic permeability was decreased by 25% and small pore radius increased by 18%. Results The simulations described well clinical data that showed a dramatic increase in ultrafiltration and sodium removal with the CIG fluid in comparison with the two other dialysis fluids. However, to adapt the three-pore model to the selected group of PD patients (fast transporters with small ultrafiltration capacity on average), the peritoneal pore structure had to be modified. As the mathematical model was capable of reproducing the clinical data, this shows that the enhanced ultrafiltration with the combination fluid is caused by the additive effect of the two different osmotic agents and not by a specific impact of the new dialysis fluid on the transport characteristics of the peritoneum.


1971 ◽  
Vol 1 (4) ◽  
pp. 317-322 ◽  
Author(s):  
S.P. Vahl ◽  
J.C. Vickery ◽  
D.M. Monro ◽  
J. Tinker

Author(s):  
F. Jacob Seagull ◽  
Danny Ho ◽  
James Radcliffe ◽  
Yan Xiao ◽  
Peter Hu ◽  
...  

Responding to medical emergencies quickly and effectively is essential. In remote or hostile environments, fully trained medical personnel are not always available, so clear and effective guidance is required. This paper reports a comparison of paper-based and computer-based checklists for just-in-time training for medical emergencies. In a between-subjects experiment, untrained participants carried out an emergency airway management task on a patient simulator either using a paper-based checklist with text and still images or using a computer-based checklist that included identical text plus video clips. Participants using the computer-based checklist performed significantly faster and more proficiently than those using the paper checklist. Subjective usability and preference measures were also superior for computer checklist. The results suggest the clear superiority of the computer-based checklist for untrained responders. We discuss which aspects of the computer-based checklist may contribute to its superiority.


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