The role of taxonomies in social media and the semantic web for health education. A study of SNOMED CT terms in YouTube health video tags.

BACKGROUND: An increasing amount of health education resources for patients and professionals are distributed via social media channels. For example, thousands of health education videos are disseminated via YouTube. Often, tags are assigned by the disseminator. However, the lack of use of standardized terminologies in those tags and the presence of misleading videos make it particularly hard to retrieve relevant videos. OBJECTIVES: i) Identify the use of standardized medical thesauri (SNOMED CT) in YouTube Health videos tags from preselected YouTube Channels and demonstrate an information technology (IT) architecture for treating the tags of these health (video) resources. ii) Investigate the relative percentage of the tags used that relate to SNOMED CT terms. As such resources may play a key role in educating professionals and patients, the use of standardized vocabularies may facilitate the sharing of such resources. iii) Demonstrate how such resources may be properly exploited within the new generation of semantically enriched content or learning management systems that allow for knowledge expansion through the use of linked medical data and numerous literature resources also described through the same vocabularies. METHODS: We implemented a video portal integrating videos from 500 US Hospital channels. The portal integrated 4,307 YouTube videos regarding surgery as described by 64,367 tags. BioPortal REST services were used within our portal to match SNOMED CT terms with YouTube tags by both exact match and non-exact match. The whole architecture was complemented with a mechanism to enrich the retrieved video resources with other educational material residing in other repositories by following contemporary semantic web advances, in the form of Linked Open Data (LOD) principles. RESULTS: The average percentage of YouTube tags that were expressed using SNOMED CT terms was about 22.5%, while one third of YouTube tags per video contained a SNOMED CT term in a loose search; this analogy became one tenth in the case of exact match. Retrieved videos were then linked further to other resources by using LOD compliant systems. Such results were exemplified in the case of systems and technologies used in the mEducator EC funded project. CONCLUSION: YouTube Health videos can be searched for and retrieved using SNOMED CT terms with a high possibility of identifying health videos that users want based on their search criteria. Despite the fact that tagging of this information with SNOMED CT terms may vary, its availability and linked data capacity opens the door to new studies for personalized retrieval of content and linking with other knowledge through linked medical data and semantic advances in (learning) content management systems.

Men with cancer change their health behaviour: a prospective study from the Danish diet, cancer and health study.

BACKGROUND: Health behaviour changes may improve the quality of life and survival among cancer survivors. We prospectively examined changes in health behaviour among and between men with prostate cancer (PC), men with cancers other than PC and cancer-free men. METHODS: We analysed data for 20 914 men (50-65 years), 426 with cancer, and 20 488 persons who were cancer-free between baseline (1993-1997) and follow-up (2000-2002) in multiple linear regression models to determine differences in changes in body mass index (BMI) and in alcohol and tobacco consumption. RESULTS: Body mass index and tobacco and alcohol consumption decreased significantly (P<0.001) between baseline and follow-up among both men with cancer and cancer-free men. Men with cancers other than PC significantly decreased their BMI (ß=-058; 95% confidence interval (CI): -0.77, -0.40) and tobacco consumption (ß=-1.36; 95% CI: -2.22, -0.49) compared with cancer-free men and were significantly more likely to quit smoking and lose weight. CONCLUSION: Men with cancers other than PC decreased their tobacco consumption and BMI significantly more than cancer-free men. Men with cancer do change their health behaviour; clinicians should take this into account in planning follow-up care for cancer survivors.

Improving the nursing documentation: professional consciousness-raising in a Northern-Norwegian psychiatric hospital.

The new Norwegian health legislation has increased the quality demands on nursing documentation. The staff at a psychiatric hospital has, together with us, explored their own way of producing written nursing documentation. In collaboration with them, we have analysed 32 patient journals which were made anonymous. We read through the documents with a critical view. We compared the findings with current professional quality standards. The actual language in the reports was analysed critically. The purpose was that the staff would become aware of unintentional consequences of their own parlance. We contributed by giving them a suitable analysis tool, which can be used for exploring own practice. The analysis tool became an aid in making the necessary qualitative improvements. This has made them change their practice. Today, the wards can exhibit documentation systems that to a large extent satisfy current professional and legal demands. An important change is the staff's specific contributions are made explicit. The staff has become more resource-oriented and the patient has, to a much larger extent than before, become an active participant in the development of the nursing plan.

Incidence and mechanisms of acute ankle inversion injuries in volleyball. A retrospective cohort study.

In a retrospective cohort study of ankle inversion injuries performed after the 1991-1992 season in the top two divisions of the Norwegian Volleyball Federation, 63 injuries were found among 318 players during 60,612 hours of training and 928 matches. The study was limited to acute ankle inversion injuries that caused an absence of 1 or more days from training or match play. The total injury rate was 0.9 +/- 0.12 per 1000 player hours: 0.7 +/- 0.11 during training and 2.6 +/- 0.56 during match play. The relative risk of injury during match play versus training was 3.9 (P < 0.001). Women had an injury rate of 1.1 +/- 0.18, whereas that of men was 0.7 +/- 0.15 (relative risk = 1.47; not significant). Most of the players (78%) had suffered at least one previous injury of the affected ankle. Most injuries were mild to moderate. The majority of the injuries (86%) occurred at the net, mainly when landing after blocking (63%) or attacking (29%). We suggest that simple measures such as rule changes, technical training, and prophylactic taping or bracing may lead to a significant reduction in the incidence and severity of such injuries.

Changes in neurotransmitter parameters in the brain induced by L-cysteine injections in the young rat.

A single subcutaneous injection of L-cysteine (1.2 mg/g body wt.) to 4-day-old rats leads to atrophy of the brains examined 27-31 days later. The brains could be separated into two groups (type 1 and 2) on account of the degree of atrophy. Type-1 lesion, with a brain weight reduction of 20%, was dominated by a severe reduction in high-affinity uptake of L-glutamate in CNS regions receiving corticofugal fibers such as thalamus and striatum. Glutamate decarboxylase was only reduced in cortical structures. In type-2 lesion, with a severe brain atrophy of about 50%, high-affinity glutamate uptake was further reduced and there was a more pronounced reduction in glutamate decarboxylase activity in several brain regions. Cholinergic neurons were less affected by the lesion and the levels of choline acetyltransferase showed a relative increase in brain regions which partly compensated for their reduction in size.

[Quality assurance of medical technical equipment]. / Kvalitetssikring av medisinsk teknisk utstyr.

Det norske Veritas has been engaged by the Ministry of Health and Social Affairs to establish measures to improve safety and efficiency in the utilization of medical equipment in Norwegian hospitals. A major effort in this respect is to help the hospitals to implement a quality system for medical equipment. This quality system is to be based on the Veritas produced Model for a Quality Manual for Medical Equipment. Det norske Veritas offers an information video and a course as a help to hospitals in implementing the system. Other remedies so far are a Standard Agreement for Purchase and Sale of Medical Equipment and, as a result of nationwide committee work, Procedure Models for Gas Anaesthesia Equipment.

Congestive heart failure and ejection fraction in acute myocardial infarction.

Left ventricular ejection fraction (EF) was determined by means of radionuclide ventriculography (RNV) in 477 patients 8-12 days after an acute myocardial infarction (AMI). EF was correlated to infarct size and clinical and radiological parameters of congestive heart failure (CHF). The 138 patients (29%) who had signs of CHF had a mean (+/- SD) EF of 35 +/- 14% and a relative heart volume of 597 +/- 112 ml/m2 compared to 51 +/- 14% and 487 +/- 88 ml/m2 among those without CHF. The 52 patients who also had radiological signs of CHF had a mean EF of 27 +/- 12% versus 35 +/- 14% among those with clinical signs and symptoms of CHF. Presence of CHF was positively correlated to the size of AMI and to the reduction of EF. CHF was seen with increasing frequency from 16% in small to 46% in large first infarctions. Patients with reinfarctions showed the same correlation between these parameters, however, with subsequently more depressed EF values and more frequent presence of CHF due to previous myocardial damage. CHF was seldom (8%) observed in patients with EF greater than 50%. In contrast, 67% of the patients with EF less than 35% had CHF. Thus patients with an EF less than 35% represent a high risk group with regard to development of CHF and should be followed closely. It is suggested that radionuclide measurement of EF adds important clinical information in patients with diagnostic uncertainty of CHF.

Cardiac performance in hyperthyroidism assessed by systolic time intervals and radionuclide ventriculography.

Systolic time intervals (STI) and radionuclide ventriculography (RNV) were used in the assessment of cardiac performance in 22 patients with hyperthyroidism before and after antithyroid treatment. STI as well as RNV showed enhanced myocardial contractility which was normalized after antithyroid treatment. Beta-blocker treatment did not influence the hypercontractility in hyperthyroidism. This implies that beta-blockers alone cannot be regarded as satisfactory long-term treatment and that mechanisms other than increased sympathoadrenal drive are involved in the hypercontractility in hyperthyroidism. RNV suggested valvular regurgitation, probably of the mitral valve, in 11 patients. Possible hemodynamic consequences are discussed.

Systolic time intervals and ejection fraction in assessing left ventricular performance following acute myocardial infarction. Comparison of systolic time intervals and equilibrium radionuclide ventriculography.

Left ventricular performance in 54 patients with acute myocardial infarction was studied by means of systolic time intervals (STI) and ejection fraction (EF) determined using radionuclide technique. The data were correlated to clinical parameters of left ventricular heart failure and size of infarction. Thirty-seven patients were studied in the convalescent period with repeated registrations at 6, 10 and 24 weeks. Patients with left ventricular heart failure had markedly depressed EF, significantly different from EF in the non-heart failure group. STI did not show any difference. A strong correlation between infarct size and EF could be demonstrated. STI discriminated significantly transmural from non-transmural infarctions, and presented significant differences between those with normal EF (greater than 50%) and patients with EF below 35%. No significant changes could be found in left ventricular performance during the convalescent period, except for an increase in corrected preejection period (PEPc) probably due to drugs. The correlation between EF and STI was poor, the highest correlation coefficient being 0.55 between EF and the ratio PEP/LVET.

Pholcodine interference in the immunoassay for opiates in urine.

The excretion in urine after single oral therapeutic doses of morphine derivatives was analysed with radioimmunoassay (RIA) and homogeneous enzyme immunoassay (EMIT) for opiates. In contrast to the rapid excretion of ethylmorphine and codeine, pholcodine showed positive results for opiates 2-6 weeks after intake when the urines were analysed with the RIA-method. When analysed with the EMIT-method, positive results were obtained for pholcodine for approximately 10 days. As pholcodine is a common component in cough mixtures, its prolonged excretion could represent a hazard in interpreting the results from drug analyses of urines.

Effects of metronidazole (Flagyl) on the determination of serum ASAT on the SMA 12/60 Auto Analyser.

Therapeutic serum concentrations of metronidazole will lead to under-estimation of ASAT activity when a SMA 12/60 Auto Analyser is used. This interference is due to metronidazole entering the colorimeter through the dialyser membrane in the SMA 12/60 Auto Analyser. This drug is one of the few with a relatively high therapeutic serum concentration, absorbing light in the 340 nm range. Metronidazole will similarily affect other 340 nm methods (LDH, ALAT) available on the SMA 12/60. This interference with metronidazole on the SMA 12/60 can easily be solved by the introduction of a separate serum blank channel for the 340 nm methods.

Intoxication with sodium valproate. A case report.

Sodium valproate is a relatively new compound in the treatment of epilepsy. A female patient was admitted to the hospital after voluntary intake of 30 g sodium valproate. Her serum concentration was 4925 mumol/l, but the course of the intoxication was mild and the patient was soporous for only 12 hours after intake of the compound. Biochemical data may suggest a slight transitory liver affection.