RESUMO
A pediatric cardiology database was designed and implemented on a microcomputer using the MEDUS/A (Harvard School of Public Health) database management system. This database has potential utility in the areas of clinical research, patient management, and administration. Initial uses of the system include a study of ventricular septal defects, and automation of pacemaker clinic and cardiac catheterization laboratory records. Clinicians with little or no programming experience can alter the database structure and tailor complicated applications to their particular needs. Preliminary evaluation of the system is presented.
Assuntos
Cardiologia , Computadores , Microcomputadores , Sistemas On-Line , Pediatria , Cateterismo Cardíaco , Criança , Comunicação Interventricular , Departamentos Hospitalares , Humanos , Prontuários Médicos , Ohio , Marca-Passo Artificial , SoftwareRESUMO
Decision analysis was done to compare the consequences of prophylactic cholecystectomy with expectant management for silent gallstone disease. Probability values were derived from a study of the natural history of silent gallstone disease, published cholecystectomy mortality rates, and life tables. The two strategies were compared by calculating cumulative numbers of person-years lost for hypothetical cohorts of men and women. Prophylactic cholecystectomy slightly decreases survival. A 30-year-old man choosing prophylactic cholecystectomy instead of expectant management would lose, on average, 4 days of life; a 50-year-old man would lose 18 days. Consideration of monetary costs and discounting further disfavors prophylactic cholecystectomy. Sensitivity analysis shows that differences between the two strategies remain small over a broad range of probability values, both for men and women.
Assuntos
Colecistectomia , Colelitíase/cirurgia , Adulto , Fatores Etários , Idoso , Sistema Biliar/fisiopatologia , Colecistectomia/efeitos adversos , Colecistectomia/economia , Colelitíase/mortalidade , Custos e Análise de Custo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Probabilidade , Fatores SexuaisRESUMO
An automated microcomputer system for monitoring heart rate and systolic time intervals (STI)--preejection period (PEP), left ventricular ejection time (LVET), and PEP/LVET--was implemented. The system, employing esophageal accelerometry, is economical and simple to operate. Being light and compact, it is therefore portable. The accuracy and reliability are no less than considerably more costly systems. The set of systolic time intervals can be measured and output in 6 sec. The system offers the advantage of monitoring STI in a larger number of surgical patients than do traditional systems due to its esophageal transducer.
