Telemedicine demonstration projects in the Western Pacific.

Telemedicine demonstration projects in the Western Pacific are attempting to provide distance medical consulting and distance medical education for the isolated health-care workforce of the region. The Picasso Phone system is a low-cost telemedicine system which requires only the standard telephone network for its operation, needs little additional equipment and is user-friendly. The demonstration projects have shown the utility of the system in both international, inter-island and on-island communications. All demonstration activities used the various existing island telephone systems. With the adaptation of such a user-friendly telemedicine system as the Picasso Phone system to the Peacesat public-interest educational network, the capacity of the telemedicine network will expand to include isolated islands with Peacesat capacity which do not have access to the commercial island telephone systems.

Netilmicin in the treatment of clinical peritonitis in chronic renal failure patients managed by continuous ambulatory peritoneal dialysis.

The efficacy and systemic absorption of netilmicin following intraperitoneal instillation were studied during ten episodes of clinical peritonitis in chronic renal failure patients managed by CAPD. Episodes were unselected for sensitivity of microorganism in vitro to netilmicin. Five subjects studied as inpatients had sequential dialysate and frequent plasma samples assayed for netilimicin up to 110 hours of therapy. Five patients who managed their peritonitis at home had dialysate and plasma netilmicin levels estimated at two and six days. In a dose of 10 mg/l, netilmicin was curative in the majority of patients (70%). Toxic blood levels were not found. Experience with netilmicin compared favourably with that observed in eight consecutive episodes of outpatient peritonitis managed with intraperitoneal cefamandole, the first line treatment for CAPD peritonitis in our unit (75% cure). No side effects were recorded with either agent. We conclude that netilmicin can be used effectively in the majority of microbiologically undifferentiated episodes of CAPD peritonitis, including in the home setting.