Intracavitary Applicator for Sequential Delivery of Localized Hyperthermia Through Non-Metallic Uterine Tandem.

In this article, we report the design and demonstration of a flexible coaxial wire antenna with a low profile flexible choke for delivering localized hyperthermia (HT) treatment to the cervix through a custom designed uterine tandem applicator. Resistive and magnetic materials were investigated for determining the flexible choke design suited for intracavitary HT treatment at 915 MHz. Measurements of the intracavitary antenna with the flexible choke in tissue mimicking phantom and ex-vivo bovine muscle through the non-metallic uterine tandem prototype confirm the ability to deliver localized HT to the cervix at 915 MHz and 50 mm insertion depth.

An international assessment of a web-based diagnostic tool in critically ill children.

Improving diagnostic accuracy is essential. The extent of diagnostic uncertainty at patient admission is not well described in critically ill children. Therefore, we studied the extent that pediatric trainee diagnostic performance could be improved with the aid of a computerized diagnostic tool.

Validation of a diagnostic reminder system in emergency medicine: a multi-centre study.

Background: Diagnostic error is a significant problem in emergency medicine, where initial clinical assessment and decision making is often based on incomplete clinical information. Traditional computerised diagnostic systems have been of limited use in the acute setting, mainly due to the need for lengthy system consultation. We evaluated a novel web-based reminder system, which provides rapid diagnostic advice to users based on free text search terms.

Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making.

Background: Diagnostic error is a significant problem in specialities characterised by diagnostic uncertainty such as primary care, emergency medicine and paediatrics. Despite wide-spread availability, computerised aids have not been shown to significantly improve diagnostic decision-making in a real world environment, mainly due to the need for prolonged system consultation. In this study performed in the clinical environment, we used a Web-based diagnostic reminder system that provided rapid advice with free text data entry to examine its impact on clinicians' decisions in an acute paediatric setting during assessments characterised by diagnostic uncertainty.

Clinical safety of Lactobacillus casei shirota as a probiotic in critically ill children.

Objective: Diarrhea is frequently observed among critically ill children (CIC) admitted for intensive care. There is increasing evidence that probiotics decrease the incidence of acute infectious and nosocomial and antibiotic induced diarrhea amongst children hospitalized in nonintensive care settings. Despite theoretic advantages for the use of probiotics in CIC, safety has remained a concern in this vulnerable group.

The role of healthcare delivery in the outcome of meningococcal disease in children: case-control study of fatal and non-fatal cases.

Objective: To determine whether suboptimal management in hospital could contribute to poor outcome in children admitted with meningococcal disease.

Design: Case-control study of childhood deaths from meningococcal disease, comparing hospital care in fatal and non-fatal cases.

Setting: National statistics and hospital records.

A novel diagnostic aid (ISABEL): development and preliminary evaluation of clinical performance.

Clinical diagnostic aids are relatively scarce, and are seldom used in routine clinical practice, even though the burden of diagnostic error may have serious adverse consequences. This may be due to difficulties in creating, maintaining and even using such expert systems. The current article describes a novel approach to the problem, where established medical content is used as the knowledge base for a pediatric diagnostic reminder tool called ISABEL.

Children with human immunodeficiency virus admitted to a paediatric intensive care unit in the United Kingdom over a 10-year period.

Objective: There is little published experience regarding the outcome of children with human immunodeficiency virus (HIV) infection treated on a paediatric intensive care unit (PICU). We describe the outcome of children with HIV infection in our hospital over a 10-year period.

Method: We performed a retrospective analysis of all children with HIV infection admitted to our PICU between August 1992 and July 2002.

Measuring the impact of diagnostic decision support on the quality of clinical decision making: development of a reliable and valid composite score.

Objective: Few previous studies evaluating the benefits of diagnostic decision support systems have simultaneously measured changes in diagnostic quality and clinical management prompted by use of the system. This report describes a reliable and valid scoring technique to measure the quality of clinical decision plans in an acute medical setting, where diagnostic decision support tools might prove most useful.

Design: Sets of differential diagnoses and clinical management plans generated by 71 clinicians for six simulated cases, before and after decision support from a Web-based pediatric differential diagnostic tool (ISABEL), were used.