Commentaries on "Informatics and medicine: from molecules to populations".

OBJECTIVE: To discuss interdisciplinary research and education in the context of informatics and medicine by commenting on the paper of Kuhn et al. "Informatics and Medicine: From Molecules to Populations". METHOD: Inviting an international group of experts in biomedical and health informatics and related disciplines to comment on this paper. RESULTS AND CONCLUSIONS: The commentaries include a wide range of reasoned arguments and original position statements which, while strongly endorsing the educational needs identified by Kuhn et al., also point out fundamental challenges that are very specific to the unusual combination of scientific, technological, personal and social problems characterizing biomedical informatics. They point to the ultimate objectives of managing difficult human health problems, which are unlikely to yield to technological solutions alone. The psychological, societal, and environmental components of health and disease are emphasized by several of the commentators, setting the stage for further debate and constructive suggestions.

Romanian medical informatics and professor Jan H. van Bemmel's support--Dr. Honoris Causa bestowed by Victor Babes University.

OBJECTIVE: The development of medical informatics education in Romania, starting from Timisoara, was strongly influenced by the support offered generously by Professor Jan H. van Bemmel, in a period when the imposed political conditions limited contacts between Western and Eastern countries. We tried to present here some of the most significant actions and events related to this long lasting collaboration. METHODS: The evolution of the relations between the Departments of Medical Informatics from Medical University in Timisoara and Erasmus University in Rotterdam is described in chronological order. RESULTS: Professor van Bemmel found appropriate ways to offer his support, adapted to each historical period. He started by sending books, journals and software, continued with support for attending conferences and then extended to more active collaborations. CONCLUSION: In 2006 professor van Bemmel was the keynote speaker of the EFMI Special Topic Conference held in Timisoara and was awarded the title of 'Doctor Honoris Causa' of the Victor Babes University of Medicine and Pharmacy.

Implementation of health information systems in Romania.

OBJECTIVES: The paper aimed to present and analyze the development of Healthcare Information Systems in Romania during the last decade. The first part was dedicated to the analysis of a large national project, HMIS--Healthcare Management Information System, and the second to the current state of the hospital information systems and primary care systems. METHODS: The approach of a "case study" was used. The description of the HMIS project comprised the objectives and its structure, implementation, results and lessons learned. This is followed by a classical short presentation of the current state at the hospital and primary care levels. RESULTS: The very modest results of the HMIS project were critically analyzed, listing the "failure factors" at various moments, both weak points of the project as well as the consequences of the structural-organizational changes within the Romanian healthcare system during the implementation. However, mainly positive results were registered in the last years at lower levels, hospitals and primary care, which can also partially be interpreted as "lesson learned". CONCLUSIONS: There are several things to be learned from the Romanian experience. Healthcare information system analysis is quite complex. Obtaining better results requires several additional measures including better education and training, adopting standards and appropriate quality assessment tools.

BioDAQ--a simple biosignal acquisition system for didactic use.

A simple non expensive device for biosignal acquisition is presented. It mainly meets the requirements for didactic purposes specific in medical informatics laboratory classes. The system has two main types of devices: 'student unit'--the simplest one, used during lessons on real signals and 'demo unit', which can be also used in medical practice or for collecting biological signals. It is able to record: optical pulse, sphygmogram, ECG (1-4 leads) EEG or EMG (1-4 channels). For didactical purposes it has a large scale of recording options: variable sampling rate, gain and filtering. It can also be used in tele-acquisition via Internet.

Medical informatics education for "allied" profiles.

Medical informatics education should be adapted for each speciality of "allied professions". In this paper we try to share from our experience with students of several profiles: medicine, dentistry, pharmacy, physio-kineto-therapy, clinical laboratory, dentistry techniques and stomatological prophylaxis.

MOBISIM--package for simulation in molecular biology.

A computer program for simulation of protein synthesis regulatory processes is described. A short theoretical background reveals the requirements of a simulation program. Our program, MOBISIM, offers several facilities and a user-friendly interface for molecular biologists. An example illustrates the graphical representation both as time evolution of the system or as phase diagram.

Modelling and simulation in medicine and life sciences.

Modelling and Simulation in Medicine and Life Sciences' was the topic of a workshop held in Copenhagen at MIE'96 and of a session in Zakopane in 1997. A survey of some of the papers presented at these meetings and selected for this issue is made. The selection was made according to the topics, referring to modelling and simulation of fundamental biological processes: dynamic behaviour of the human respiratory system, wave propagation in normal and infarcted myocardium, electrical field generated by the heart, human chest conductivity, and depth perception in binocular vision.

Modeling and simulation in molecular pharmacology.

A stochastic simulation program of drug-receptor interaction is presented. The user can select a set of conditions concerning the processes of response release (type of cellular response, drug distribution and metabolism etc.) and the program plots a family of dose-response curves. A comparison between experimental and simulated dose-response curves shows the validity of the model can be used either for testing hypotheses concerning drug-receptor interaction, for experimental design or for estimation of some specific parameters. The program can also be used for educational purposes.

Health informatics education for pharmacy students in Romania.

The objectives and the curriculum of the health informatics course for pharmacy students at the University of Medicine and Pharmacy in Timisoara is presented. The relations with other disciplines and the integration into the overall educational program are discussed within the frame of the specific requirements of a pharmacy school. A description of our specific programs for pharmacy students devoted to laboratory works is also presented.

Strategy for Medical Informatics Education at the University of Medicine and Pharmacy in Timisoara.

Our strategy for adapting a curriculum in medical informatics for medical students is presented. After a brief overview, some specific conditions are addressed, which account for some peculiarities of the objectives of our courses and of the design of the curriculum, including its integration in the overall medical curriculum. Some efforts concerning examinations and some specific educational tools are then discussed. The paper also deals with particular features concerning medical informatics education for dentistry and pharmacy students as well as for postgraduate courses, paying special attention to the doctoral level. Finally, future perspectives of medical informatics education are discussed. The paper does not present a list of successes and achievements. We had, and still have several difficulties (not always related to financial drawbacks), which required a particular approach; the word "strategy'; in the title is also meant to cover these aspects.

Classification criteria for simulation programs used in medical education.

Simulation programs are often used in medical education and their large variety allows a classification according to several criteria. A system of eight axes is proposed here for such a classification: topic area, system level, simulated feature, basic model, main purpose, results presentation, warnings, and evaluation.

Influence of drugs and ionic gradients on gastric secretory epithelium in vitro.

The first part of the paper is devoted to the description of the data acquisition system for studies on epithelial membranes using a process-control computer ECAROM connected to the usual two half-chambers device for epithelial transport studies in vitro. The second part presented the results obtained in several types of experiments concerning the effect of drugs (histamine, acetazolamide) and ionic gradients (K+, Cl-, H+) on the potential difference and/or acid secretion rate.

Phenylephrine interaction with specific red cell receptors.

An investigation of the action of phenylephrine on the transport of sodium across the human cell membrane is reported. The characteristic parameters of drug-receptor interaction -- the maximal response and ED50 -- were calculated based on the conventional dose-response plot and its linear transformations. The results obtained were in good agreement with other experimental findings.