The Spectrum of Inherited Gray Matter Degenerative Brain Disorders (DBD) in Children: A Single-Center Study.

Objectives: To study the clinical spectrum of inherited gray matter degenerative brain disorders (DBD) in children.

Methods: This cross-sectional study evaluated children up to 12 y of age, diagnosed with an inherited gray matter DBD in a tertiary care pediatric hospital between July 2019 and December 2020.

Results: A total of 314 children with progressive neuroregression were screened.

A comparative evaluation of thoracic and lumbar epidural fentanyl for post thoracotomy pain.

Thirty patients undergoing closed mitral valvotomy were prospectively randomised to receive either thoracic or lumbar epidural catheter. General anaesthesia consisted of morphine sulphate 0.15 mg/kg (single dose given before skin incision), thiopentone sodium 4-6 mg/kg, vecuronium and halothane titrated to stable haemodynamics.

SAGEDesktop: an environment for testing clinical practice guidelines.

Clinical practice guidelines have begun to appear in electronic form with the expectation that they will be used to provide automated clinical decision support. Systems capable of executing these clinical practice guidelines are emerging concurrently. A few research projects have developed guideline authoring tools that allow encoding electronic clinical practice guidelines.

Executing clinical practice guidelines using the SAGE execution engine.

We report the first successful test of an interoperable guideline execution engine that interprets encoded clinical guideline content and executes that content via functions of a target clinical information system (CIS). For this test, an exemplar immunization guideline was encoded in the SAGE guideline model using standards-based information models and terminologies. This guideline content was subsequently executed using the prototype SAGE guideline execution engine, which interacts through standards-based VMR/Action services to instantiate real-time guideline recommendations via existing functions of the target CIS.

Modeling guidelines for integration into clinical workflow.

The success of clinical decision-support systems requires that they are seamlessly integrated into clinical workflow. In the SAGE project, which aims to create the technological infra-structure for implementing computable clinical practice guide-lines in enterprise settings, we created a deployment-driven methodology for developing guideline knowledge bases. It involves (1) identification of usage scenarios of guideline-based care in clinical workflow, (2) distillation and disambiguation of guideline knowledge relevant to these usage scenarios, (3) formalization of data elements and vocabulary used in the guideline, and (4) encoding of usage scenarios and guideline knowledge using an executable guideline model.