ABSTRACT
The potential of electronic communication in medicine is assessed based on an analysis of a pilot project pertaining to internet based communication among referring and hospital physicians. Advantages of electronic data exchange in medicine pertain to speed and capacity for data transfer, availability of data and data integration, ultimately enabling consistent medical case management. Quality requirements of electronic communication of medical data are related to safety, availability, data integration, potential for case management and system qualities. Medical efficiency can be increased by use of electronic communication only if complex functions beyond the substitution of conventional mail by e-mail are implemented and an exhaustive use of the technology can be achieved.
Subject(s)
Hospital Information Systems , Internet , Medical Records Systems, Computerized , Patient Care Team , Referral and Consultation , Case Management , Family Practice , Hospitals, University , Humans , Interprofessional Relations , SwitzerlandABSTRACT
BACKGROUND: Polyclonal elevation of immunoglobulins is classically described in sarcoidosis and could possibly be useful in the work-up of suspected sarcoidosis uveitis. Because exposure to viruses of the herpes group is high in all populations, determination of herpes serologies is probably suited for this purpose. PATIENTS AND METHODS: Therefore serum anti-herpes antibody patterns in sarcoidosis (SARC), HLA-B27 positive acute anterior uveitis (AAU), pars planitis (PP) and healthy age-matched controls were analysed. Frozen sera were analysed for exposure to CMV, HSV, VZV by ELISA IgG testing and to EBV-VCA by immunofluorescence. Complement fixing titers > or = 1/40 and an EBV-VCA titer > or = 1/1280 were considered elevated. For each patient exposed to 2 or more herpes viruses, a score made out of the number of elevated titers divided by the number of herpes viruses the patient was exposed to, was calculated and mean scores were compared using Student's t-test. RESULTS: Mean score of patients with sarcoidosis was 0.47 +/- 0.27 (N = 18, mean age 60.2 +/- 21.4 years), significantly higher than AAU (N = 21; score 0.12 +/- 0.2; p < or = 0.000), than PP (N = 20; score 0.18 +/- 0.2; p < 0.003), and than age-matched healthy controls (N = 341, mean age 59 +/- 5.5 years; score = 0.15 +/- 0.14; p < 0.000). CONCLUSION: Anti-herpes antibodies were found to be significantly elevated in sarcoidosis uveitis, suggesting that herpes serologies may be useful in the work-up of suspected ocular sarcoidosis, a disease for which sufficiently sensitive and specific tests are lacking.
