Seroprevalence of antibodies to Bartonella henselae in patients with cat scratch disease and in healthy controls: evaluation and comparison of two commercial serological tests

As the National Library of Medicine expands access to its products and services by making them available on the Internet, more accurate information about current and future access in medical libraries is needed. The National Network Office of the National Library of Medicine conducted a survey of all network member libraries to determine the extent of connectivity and the barriers preventing 100% connectivity. Respondents called a toll-free number and, using interactive voice technology, answered questions concerning Internet access in their library. Seventy-eight percent of the network member libraries responded. Four percent of academic libraries, 27% of hospital libraries, and 10% of "other" libraries reported that they were not connected. Computer cost, lack of in-house expertise, and lack of management support were the highest ranked barriers to connecting. The National Library of Medicine and the Regional Medical Libraries will use information from this survey to develop strategies to help all member libraries achieve full connectivity.     

Laparoscopic surgery and the systemic immune response

New York Online Access to Health (NOAH) is a Web site that provides accurate, timely, relevant, and unbiased full-text health information in both English and Spanish. A joint project of The City University of New York Office of Library Services, The New York Academy of Medicine Library, the Metropolitan New York Library Council, and The New York Public Library, NOAH brings consumer health information to the public in New York City and around the world via the Internet. NOAH is an example of a successful collaboration among different types of libraries (academic, public, medical society) and voluntary health agencies to use new technologies to reach a very broad public. This paper discusses the involvement of the library partners in terms of the management and funding of the site. Web site construction is described including how the information is gathered and organized. Future plans and funding issues for NOAH are considered in terms of the expected increase in the need for consumer health information. NOAH can be reached at: www.noah.cuny.edu.     

Endothelial protective effect of stobadine on ischaemia/reperfusion-induced injury

A pedagogical network has been developed at University Hospital of Rennes from 1996. The challenge is to give medical information and informatics tools to all medical students in the clinical wards of the University Hospital. At first, nine wards were connected to the medical school server which is linked to the Internet. Client software electronic mail and WWW Netscape on Macintosh computers. Sever software is set up on Unix SUN providing a local homepage with selected pedagogical resources. These documents are stored in a DBMS database ORACLE and queries can be provided by specialty, authors or disease. The students can access a set of interactive teaching programs or electronic textbooks and can explore the Internet through the library information system and search engines. The teachers can send URL and indexation of pedagogical documents and can produce clinical cases: the database updating will be done by the users. This experience of using Web tools generated enthusiasm when we first introduced it to students. The evaluation shows that if the students can use this training early on, they will adapt the resources of the Internet to their own needs.     

Gastric and duodenal anti-ulcer activity of sulpiride, a dopamine D2 receptor antagonist, in rats

The buildings in which we house libraries are like other special purpose structures; the needs they fill are significantly influenced by technology. A prime function of the library building is to house collections (of people, material, and systems) as well as collections of collections (networks). Electronic formats for library material offer new approaches to information service delivery. An example, the information access station, typifies how traditional functions can be reconfigured with respect to space. Flexible design can help ensure that tomorrow's libraries meet the users' needs, but we need to question all our assumptions about building design including those driven by our understanding of the browsing process.     

Information retrieval patterns and needs among practicing general surgeons: a statewide experience

Information retrieval has progressed from a reliance on traditional print sources to the modern era of computer databases and online networks. Surgeons, many from remote areas not served by professional medical libraries, must develop and maintain skills in information retrieval and management in both electronic and standard formats. One hundred thirty-three New Mexico general surgeons were surveyed to identify their information-seeking patterns in five areas: retrieval purposes, retrieval sources, barriers to access, techniques used, and continuing education needs. Ninety-nine (74.4%) surgeons responded to the survey. Ninety-five percent utilize professional meetings, the medical literature, and physician colleagues as information sources. Only 17% utilize the outreach services of the state's only medical school library. Common retrieval barriers were practice demands (71%), isolation from medical schools (30%), computer illiteracy (28%), and rural environment (25%). Continuing education topics related to information management would be valuable to 61% of the surgeons. Sixty-nine percent believe their current ability to access biomedical information is adequate, despite most frequently accessing their personal libraries for information related to decision-making or patient management. These data suggest that, despite significant information needs, surgeons have not embraced newer forms of information retrieval. It is imperative that surgeons acquire and maintain modern information retrieval skills as a means of remaining up-to-date in their profession. Professional surgical organizations and medical librarians should collaborate on these continuing education ventures.     

Fifteen-year experience in axillofemoral bypass with externally supported knitted Dacron prosthesis in a Japanese hospital

Physicians and patients need convenient access to quality medical information. This study's goal was to place a medical resource on the World-Wide Web (WWW), allow access to it through a simple to use interface, and analyze the usage of such a resource. The Family Practice Handbook (TFPH) was digitized and placed onto the WWW. Usage data was obtained from June 1995-June 1996. 118,804 individuals accessed TFPH viewing 409,711 pages of information. A broad spectrum of topics was accessed. TFPH proved to be an extremely popular resource, servicing the broad information needs of an international audience. These preliminary findings suggest the future promise of Internet medical resources.     

Multimedia image and data navigation workstation

World Wide Web (WWW) standards have been established for the transmission of and remote consultation on medical information and records, including medical images, extracted from an existing hospital information system. A software package called Osiris is being used for the display and manipulation of medical images in a hospital-based picture archiving and communication system. Recent extensions of Osiris, through the integration of WWW navigational tools, allow easy access to a variety of clinical data from patient records. A special interface allows access to radiologic images, laboratory results, and related textual information through public-domain software programs. These technologic advances offer medical professionals the convenience and ease of use that have made WWW and Internet navigation so popular in the academic community.     

The Sociedad Espa?ola de Cardiología on the Internet: current resources and future prospects. The Internet Committee of the Sociedad Espa?ola de Cardiología

The Internet can help physicians to identify needed clinical information quickly providing continued medical education. Internet also improves medical information of the non-medical population. Researchers have quick access to library catalogs, Medline and other important databases from the most recognized research centers. Furthermore, it can put physicians in ready contact with other specialists for communication and consultation, facilitates administrative procedures of multicenter studies and accelerates editorial processes of biomedical journals. Since its creation, the website of the Spanish Society of Cardiology has evolved rapidly to the present model, providing different kinds of services to its members including faster communication, information from national and international societies and congresses, earlier access to the full content of Revista Espa?ola de Cardiología and to a variety of graphic resources and of continuing education. Nowadays, the website of the Spanish Society of Cardiology is consulted by one thousand visitors a week, even at weekends. The degree of activity increases from 3 h P.M. with a peak from 11 h P.M. to 1 h A.M. In the near future, our website will incorporate its own courses of continuing medical education with on-line evaluation and credit granting, will give support to multicenter studies and will initiate the publication and discussion of clinical cases of interest.     

Medical information on the Internet

Connecting to the Internet allows health care professionals to access medical information at computer sites worldwide, to search databases, communicate with peers, obtain continuing education, retrieve images and software, obtain drug information and access statistical data. Users can access sites with "virtual patients," search library catalogs, locate jobs and post resumes, and explore conference sites and topics. Rural health care professionals can have access to medical information equivalent to their urban peers. Information is usually available over the Internet much more rapidly than through traditional print methods.     

Immobilizing vacuum litters, IVL

There is increasing emphasis on continuing education of hospital personnel, who need and want access to information in order to be aware of advances in health care. Small hospitals cannot afford to duplicate extensive collections. Personnel of hospitals that are remote from urban centers often do not have opportunities to visit a resource library on a regular basis and do not have experience in searching the medical literature through the use of reference tools. It is increasingly evident that the circuit librarian program has served as a catalyst in establishing relationships between the hospitals and the university health sciences center. The director of the CHSL has consulted with the deans of the nursing and the medical schools and with various professors. They have promised that the schools will try to address identifiable continuing education needs or requests from the hospitals. Moreover, the circuit librarian meets with individual hospital personnel and then obtains information for them from the CHSL and its staff. The circuit librarian program is one way to meet community hospitals' needs for access to health sciences literature and to initiate peer interaction for information exchange.     

Intelligent medical information filtering

This paper describes an intelligent information filtering system to assist users to be notified of updates to new and relevant medical information. Among the major problems users face is the large volume of medical information that is generated each day, and the need to filter and retrieve relevant information. The Internet has dramatically increased the amount of electronically accessible medical information and reduced the cost and time needed to publish. The opportunity of the Internet for the medical profession and consumers is to have more information to make decisions and this could potentially lead to better medical decisions and outcomes. However, without the assistance from professional medical librarians, retrieving new and relevant information from databases and the Internet remains a challenge. Many physicians do not have access to the services of a medical librarian. Most physicians indicate on surveys that they do not prefer to retrieve the literature themselves, or visit libraries because of the lack of recent materials, poor organisation and indexing of materials, lack of appropriate and available material, and lack of time. The information filtering system described in this paper records the online web browsing behaviour of each user and creates a user profile of the index terms found on the web pages visited by the user. A relevance-ranking algorithm then matches the user profiles to the index terms of new health care web pages that are added each day. The system creates customised summaries of new information for each user. A user can then connect to the web site to read the new information. Relevance feedback buttons on each page ask the user to rate the usefulness of the page to their immediate information needs. Errors in relevance ranking are reduced in this system by having both the user profile and medical information represented in the same representation language using a controlled vocabulary. This system also updates the user profiles, automatically relieving this burden from the user, but also allowing the user to explicitly state preferences. An initial evaluation of this system was done with health consumers using a web site on consumer health. It was found that users often modified their criteria for what they considered relevant not only between browsing sessions but also during a session. A user's criteria for what is relevant is constantly changing as they interact with the information. New revised metrics of recall and precision are needed to account for the partially relevant judgements and the dynamically changing criteria of users. Future research, development, and evaluation of interactive information retrieval systems will need to take into account the users' dynamically changing criteria of relevance.     

Difference in microbes contaminating pancreatic necrosis in biliary and alcoholic pancreatitis

The World-Wide Web is an unstructured, multimedia and multilingual information network. While most efforts have addressed the structuring issue, very few attempts have been proposed to provide support for multilingual information retrieval. Yet, medical information is now available all over the world. The MARVIN (Multi-Agent Retrieval Vagabond on Information Network) softbot and its associated medical search engine MedHunt (Medical Hunter) are a solution for helping people, who only understand a few languages, to access multilingual information.     

Relationship between response to interferon therapy and detection of hepatitis C virus RNA by differential flotation centrifugation

Problem-based learning (PBL) is a method of instruction gaining increased attention and implementation in medical education. In PBL there is increased emphasis on the development of problem-solving skills, small group dynamics, and self-directed methods of education. A weekly PBL conference was started by a university consultation psychiatry team. One active consultation service problem was identified each week for study. Multiple computerized and library resources provided access to additional information for problem solving. After 1 year of the PBL conference, an evaluation was performed to determine the effectiveness of this approach. We reviewed the content of problems identified, and conducted a survey of conference participants. The most common types of problem categories identified for the conference were pharmacology of psychiatric and medical drugs (28%), mental status effects of medical illnesses (28%), consultation psychiatry process issues (20%), and diagnostic issues (13%). Computerized literature searches provided significant assistance for some problems and less for other problems. The PBL conference was ranked the highest of all the psychiatry resident educational formats. PBL appears to be a successful method for assisting in patient management and in resident and medical student psychiatry education.     

Departmental libraries: why do they exist?

In response to an increasing concern on the part of the library staff over the role of the departmental libraries at The Milton S. Hershey Medical Center of The Pennsylvania State University, a questionnaire was developed by the George T. Harrel Library and sent to departmental libraries. From the analyzed responses, the authors were able to define the role of departmental libraries in a medical school/hospital situation, to analyze the Hershey Medical Center situation in an objective manner, to outline areas of possible cooperation between the main and departmental libraries, and to delineate some trends which appear to result from inadequate finding of a central library. Overall, the library found that departmental libraries at Hershey are currently maintaining collections consistent with the functional role of a departmental library.     

Cellular accumulation and biological activity of hematoporphyrin derivative(L) in comparison with photofrin II

The medical specialist emerged as a critical gatekeeper in a study of information sources used by family practitioners in New Zealand. Thirty-four practitioners in the Wellington region were interviewed and their responses examined to ascertain the extent to which five criteria influenced their choice of information sources for clinical decision-making. The criteria were availability, searchability, understandability, credibility, and applicability. Of three major information sources investigated (textbooks, colleagues, and medical specialists), textbooks were consulted most frequently but were rated less valuable than colleagues and specialists as a source of information. The medical specialist was identified as the information source that best meets the five criteria. Thus, specialists play an important role in disseminating information to family practitioners. However, female practitioners included in the study were less likely to approach specialists than were their male counterparts. Physicians made little use of medical libraries to support clinical decision-making. The apparent disadvantage of female practitioners in accessing specialists needs to be addressed by professional associations. Medical librarians seeking to improve the access of family practitioners to recent literature should consider the heavy use made of specialists as a source of information.     

Analysis of colorectal cancer by comparative genomic hybridization: evidence for induction of the metastatic phenotype by loss of tumor suppressor genes

A method is described for measuring the diversity of combinatorial oligonucleotide libraries that entails extrapolating the base composition of a co-synthesized model library (dNC, N = A, C, G, T) to that of a multibase library template. The base composition of dNC was measured by HPLC. The ability of dNC to predict the base composition of a multibase library template was corroborated by measuring the composition of a 12 base combinatorial library. The base composition of the 12 base library was determined by several template dependent incorporation assays: measurement of restriction fragment specific activities from polymerase incorporation/restriction enzyme digests, template directed radionucleotide primer extension and quantitative dideoxynucleotide sequencing. Additionally, a convention for describing oligomeric combinatorial library (OCL) diversity is proposed. The convention uses a quantity termed the diversity quotient (Qd) to describe library breadth and the mole fraction of the least represented monomeric unit of the OCL to calculate minimum library quantity requirements. Similar methods/conventions could presumably be developed/adopted for non-nucleic acid libraries.     

Using modern information technology to profile faculty activities

Most academic medical centers (AMCs) have developed mechanisms for tracking the financing of their faculty members' research and clinical activities. However, information systems for managing and reporting financial data often do not provide fully accurate or complete pictures of the accomplishments of an institution or its faculty. Modern information technology can help AMCs integrate more extensive information about their faculties from many different sources; in particular, Web publishing technologies permit large numbers of users to have easy secure access to databases across different platforms. The authors briefly describe five faculty information systems now in use. They then describe in detail the development and implementation of one of these systems, The Johns Hopkins University School of Medicine Faculty Information System (FIS), which uses Web publishing technologies, collecting and making available information about the clinical, teaching, and research activities of faculty members.