Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2002
Lateral spinal profile in school-screening referrals with and without late onset idiopathic scoliosis 10 degrees-20 degrees.
The aim of this report is a) to study the lateral spinal profile, (LSP), in school-screening referrals with and without late onset idiopathic scoliosis of small curves 10 degrees - 20 degrees Cobb angle and b) to validate LSP's aetiological importance in idiopathic scoliosis pathobiomechanics. ⋯ The observed differences of the LSP are mainly located at the lumbar spine, suggesting that factors acting on the lumbar spine in sagittal plane contribute to the development of AIS. The minor hypokyphosis of the thoracic spine and its minimal differences observed in the studied small curves with nonscoliotics in this report add to the view that the reduced kyphosis, by facilitating axial rotation, could be viewed as being permissive, rather than as aetiological, in the pathogenesis of idiopathic scoliosis.
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Esophageal intubations are performed for urgent airway control in injured patients. Current methods of training include working on cadavers and mannequins, which lack the realism of a living human being. Work in this field has been limited due to the complex nature of simulating in real-time the interactive forces and deformations which occur during an actual patient intubation. ⋯ The two haptic devices along with the real-time performance of the simulator give it both visual and physical realism. The three dimensional viewing and interaction available through virtual reality make it possible for physicians, pre-hospital personnel and students to practice many esophageal intubations without ever touching a patient. The ability for a medical professional to practice a procedure multiple times prior to performing it on a patient will both enhance the skill of the individual while reducing the risk to the patient.
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Stud Health Technol Inform · Jan 2002
Clinical TrialIn vivo quantitative analysis of scoliotic vertebrae.
An in vivo method based on CT images and finite element meshing had been developed to quantify and visualize the bone density distribution of scoliotic vertebrae. CT examination (axial acquisition of the apical, superior and inferior adjacent vertebral bodies) had been performed on seven girls presenting an idiopathic scoliosis. Using an in-house image processing software and the pre-post processor Patran, a surfacic finite element mesh of each body slice was proposed allowing an automatic mapping of the cancellous bone slices and a volumic mesh for the bone density distribution visualization. ⋯ The shift forward by slice was made in a same way for each slice, excepted at the end plates. Besides, one can observe that the scoliotic deformation evolution seemed to modify the mechanical property distribution. The results may also suggest predictive criteria of evolution of the scoliotic deformities.
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Stud Health Technol Inform · Jan 2002
Sagittal and transversal plane deformity in thoracic scoliosis.
The aim of the study was to assess the sagittal and transversal plane deformity of the spine in thoracic scoliosis by the mean of 3-D radiographic analysis. 46 patients admitted for surgery for thoracic idiopathic scoliosis underwent preoperative radiographic assessment. All patients presented the same pattern of the coronal plane deformity: single right thoracic curve (Lenke 1, King 3). Neither lumbar nor proximal thoracic structural curve were present. The Cobb angle varied from 41gamma to 77 gamma (mean 55,4 gamma +/- 8,6 gamma). Long cassette standing antero-posterior and lateral radiographs were analysed. Three-dimensional reconstruction with Rachis 91TM software was performed for each pair of radiographs. The following parameters were assessed: sagittal thoracic Cobb angle (Th4-Th12), upper thoracic kyphosis angle (Th5-Th8), lower thoracic kyphosis angle (Th9-Th12), superior and inferior hemi-curve sagittal angles, lumbar lordosis, sacral slope, sacral incidence, vertebral plate index, segmental vertebral axial rotation throughout the thoracic and lumbar spine. Results showed great variability of parameters assessed. The non-harmonious distribution of kyphosis was demonstrated in the thoracic spine. Local Th9-Th12 hypokyphosis and adjacent local Th5-Th8 hyperkyphosis constitute the most typical sagittal pathologies. So called normokyphotic curves were composed of one hyperkyphotic and one hypokyphotic zone. Th1-Th4 segment revealed two patterns of segmental rotation distribution: a purely compensatory curve with no vertebral axial rotation or a rotated curve presenting the morphology intermediate between Lenke 1 and Lenke 2 types (or King 3 and King 5). ⋯ curves presenting the same coronal plane deformity differ in their morphology assessed in the two other planes; global thoracic kyphosis angle is a misleading parameter because it covers hypo- and hyperkyphotic zones; local distal thoracic (Th9-Th12) hypokyphosis is present in idiopathic thoracic scoliosis.
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Stud Health Technol Inform · Jan 2002
Trust me, I'm a patient! The effect of an EHR on my consultation.
A general assumption has been made within the health care community that the introduction of an Electronic Health Record (EHR) is beneficial and improves clinical care. However, it is my contention as both a Health Informatician, and more importantly a patient, that this assumption is not supported by evidence, either scientific or anecdotal. However, to my mind of more importance than this is the complete lack of understanding about how using an EHR effects my consultation. This paper discusses this issue and identifies four lessons to be learned by the EHR community.