ABSTRACT
Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.
Subject(s)
American Medical Association , Information Dissemination , Internet , Medical Informatics , Editorial Policies , Internet/standards , Medical Informatics/standards , United StatesABSTRACT
Use of the Internet to access health and medical information has grown significantly in the past several years and is projected to increase among physicians alone by 25% to 43% in the next year. Three obstacles face individuals searching for medical information on the Web-accessing the desired information, assessing the quality of the information found, and applying the information in the person's life. This article provides guidance on overcoming each of these obstacles.
Subject(s)
Community Participation , Internet/statistics & numerical data , Diffusion of Innovation , Humans , MEDLINE , Patient Education as TopicSubject(s)
Medicine , Acne Vulgaris , American Medical Association , Blood Transfusion , Contraceptives, Oral , Endoscopy/trends , Environmental Exposure , Female , Genetics, Medical , Humans , Male , Menopause , Physicians, Family/supply & distribution , Schizophrenia , Sexually Transmitted Diseases , Sleep Initiation and Maintenance Disorders , United StatesABSTRACT
The effect of hypervolemic-hemodilution, with and without hypertension, on blood-brain barrier permeability was investigated in rats, after 180 minutes of middle cerebral artery occlusion (MCAo), and 60 minutes of reperfusion. One of the following conditions was maintained during MCAo: 1) Control--hematocrit and blood pressure were not manipulated; 2) Hypervolemic-Hemodilution/Normotension--the hematocrit was decreased to 30%; 3) Hypervolemic-Hemodilution/Hypertension--the hematocrit was decreased to 30% and mean arterial pressure increased by 30 mmHg with phenylphrine. In all groups, Evans Blue was administered, and its concentration determined by spectrophotometric assay. Evans Blue (micrograms (g-1 of brain tissue [mean +/- SD]) was greater in the Hypervolemic-Hemodilution/Hypertension group (71 +/- 20) versus the Control (13 +/- 9) and Hypervolemic-Hemodilution/Normotension (17 +/- 10) groups (p less than 0.05). No other differences were present. These results support the hypothesis that during MCAo, hypervolemic-hemodilution/hypertensive therapy effects an increase in blood-brain barrier permeability in the early period of reperfusion.
