Paragraph-oriented structure for narratives in medical documentation.

The authors present a 6 years experiment using a document- centered electronic patient record, based on a central document repository. The document management system is paragraph oriented and all documents are built automatically before editing using predefined ordered sets of para-graphs. Paragraphs can be preloaded with templates, text or images.

The bridge between administrative and clinical information system.

On one side, physicians are asked to record administrative information, such as activity measurement, case-mix of their specialty, billing, for statistical, legal or reimbursement purposes; and on the other side, they need to gather detailed information about their own patients in terms of clinical evolution, for the day-to-day care of the patients or for clinical research purposes. Many other actors are also involved with these processes, both on the administrative side, such as registration officers, administrators and on the clinical side, nurses and other care providers. Applications have been developed within hospital information systems for capturing and disseminating information according to these specific actors and dedicated purposes.

Happy birthday DIOGENE: a hospital information system born 20 years ago.

Since its birth in 1978, DIOGENE, the Hospital Information System of Geneva University Hospital has been constantly evolving, with a major change in 1995, when migrating from a centralized to an open distributed architecture. Since a few years, the hospital had to face health policy revolution with both economical constraints and opening of the healthcare network. The Hospital Information System DIOGENE plays a significant role by integrating four axes of knowledge medico-economical context for better understanding and influencing resources consumption the whole set of patient reports and documents (reports, encoded summaries, clinical findings, images, lab data, etc.

Medical office automation integrated into the distributed architecture of a hospital information system.

Patient histories, discharge summaries, and medical consultant reports are made up of written texts. Therefore, the gathering and archiving of these texts in machine-readable form has many characteristics of computer-based medical records. In Geneva, approximately 1,540 PCs are connected to the Hospital Information System DIOGENE 2, with the possibility of accessing all the functions offered by the system without losing any of their MS-DOS word processing capabilities.

[Role of metabolites in the relationship between pharmacokinetics and the effect of beta blockers. Studies on tolamolol and bufuralol].

Plasma concentrations of tolamolol and bufuralol (beta-blocking agents) were measured after oral and intravenous administration to healthy volunteers. The plasma levels of their main metabolite was also determined. Simultaneously, the effect of the drugs on the heart rate and blood pressure was monitored under various stimuli (isoproterenol, exercise or orthostatism) and Valsalva maneuver.

[Side effects of nalidixic acid in a patient with severe renal failure. Clinical study and proposal of a pharmacokinetic model].

Side effects due to ingestion of nalidixic acid in a 46 year old patient with phenacetine-induced interstitial nephritis and severe renal failure are reported. This observation underlines the point that, besides the direct neurotoxic effect of nalidixic acid, disturbance of the acid-basic equilibrium could be seen in patients with renal failure in particular. A hypothetical pharmacokinetic model suggests that two metabolites of nalidixic acid could provide enough hydrogen ion to induce acidosis in cases of renal failure.

[Pharmacokinetics of two beta blocking drugs: detection of a pharmacogenetic abnormality].

10 healthy male volunteers received orally either 100 mg tolamolol or 20 mg bufuralol. These experiments were repeated by intravenous administration of 10 and 5 mg respectively of these two drugs. Plasma levels of the parent drugs and their main metabolite were measured.

[Clinical pharmacokinetics].

The action of a drug depends on the quantity which reaches the site of its pharmacological action and how long it remains there. The necessary vital processes of the body dilute the active principle into different compartments of distribution, transform it into metabolites, and excrete it. Since a time duration of drug presence at the site of action is vital for the cure of disease, a comprehensive and quantitative expression of these time courses of drug distribution as a function of dose and route of administration is necessary for the establishment of proper dosage regimens for the treatment of disease and the avoidance of toxicities.

A strategy of approaching the fit of a compartmental model applied to the behaviour of aspirins in humans.

A compartmental model has been set up with five parts. Formulation and testing of the model have been performed by simultaneous experiments involving measurement of blood levels of ASA and SA for four different preparations of aspirin investigated in four different patients. The hypotheses of the present study had been based upon a four-compartment model.