Regulation of a novel skeletal muscle signaling center at the occipitocervical somite boundary

Contents the entire data-set of the cohort of patients hospitalized at the Nap Kenbe Hospital Haiti that served to establish the model. (CSV 252 kb

Open source electronic health record and patient data management system for Intensive Care

Background and objectives: In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed a PDMS and EHR based on open source software and components.Methods: The software was designed as a client-server architecture running on the Linux operating system and powered by the PostgreSQL data base system. The client software was developed in C using GTK interface library. The application offers to the users the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications, scoring systems for classification, and possibilities to encode medical activities for billing processes. Results: Since his deployment in February 2004, the PDMS was used to care more than three thousands patients with the expected software reliability and facilitated data management and review processes. Communications with other medical software were not developed from the start, and are realized by the use of the Mirth HL7 communication engine. Further upgrade of the system will include multi-platform support, use of typed language with static analysis, and configurable interface. Conclusion: The developed system based on open source software components was able to respond to the medical needs of the local ICU environment. The use of OSS for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system. © 2008 The authors and IOS Press. All rights reserved.SCOPUS: cp.pinfo:eu-repo/semantics/publishe

Open source electronic health record and patient data management system for intensive care.

In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed a PDMS and EHR based on open source software and components. The software was designed as a client-server architecture running on the Linux operating system and powered by the PostgreSQL data base system. The client software was developed in C using GTK interface library. The application offers to the users the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications, scoring systems for classification, and possibilities to encode medical activities for billing processes. Since his deployment in February 2004, the PDMS was used to care more than three thousands patients with the expected software reliability and facilitated data management and review processes. Communications with other medical software were not developed from the start, and are realized by the use of the Mirth HL7 communication engine. Further upgrade of the system will include multi-platform support, use of typed language with static analysis, and configurable interface. The developed system based on open source software components was able to respond to the medical needs of the local ICU environment. The use of OSS for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system

Coronary vasospasm after myocardial revascularisation treatment by verapamil

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Spinal anesthesia :Smaller needles, higher levels

Introduction :The use of small gage pencil-point spinal needles may lead to sacral maldistribution of local anesthetics if the direction of the side - port opening is caudal and injection rate too slow (1). The purpose of this study was to observe if rapid injection of local anesthetics via a 27G Whitacre needle led to higher sensitive block levels compared to a 24G Sprotte needle. Methods :20 ASA I or II patients scheduled for elective orthopedic surgery of the lower limbs were randomized in two groups after 1KB approval and verbal consent. The two groups received a standard infusion line with 500ml lactate-Ringer solution. The first group received a combined spinal epidural anesthesia in a sitting position at L2 - L3 interspace via a 17G Tuohy-Weiss needle with loss of resistance to air after which a 27G long spinal needle with the side-port in a cephalad direction was inserted and 3ml heavy bupivacaine were injected in 10 seconds after obtaining free flow of CSF. The second group received spinal anesthesia in the same position with a 24G Sprotte needle with the side-port in a cephalad direction and received the same amount of heavy bupivacaine in 10 seconds. In the two groups, patients were placed supine four minutes after the spinal. All patients were monitored with one lead ECG, SpO2 and N1BP. Sensitive block levels were measured in the midline with ether every five minutes from 5 to 40 minutes after the spinal. Blood pressure was closely monitored and a 20% decrease or a blood pressure < 100 nunHg was treated by atropine or ephedrine or phenylephrine depending on the heart rate. Results :The two groups were demographically comparable. Sensitive block levels were significantly higher in the 27G group from 20 to the end of the measurements. At 20 minutes, mean levels in thoracic dermatomes were :5.6 in the 27G group and 7.8 in the 24G group ( p=0.024 / Mann-Whitney). At 25 minutes, mean levels in thoracic dermatomes were :5.1 in the 27G group and 7.1 in the 24G group ( p=0.015 ). At 30,35 and 40 minutes, mean levels in thoracic dermatomes were :5 in the 27G group and 7 in the 24G group ( p<0.025 ). The use of vasopressors was not different between the two groups. Conclusions :We observed higher sensitive block levels with a mean difference of two dermatomes when we performed fast injection through a 27G Whitacre spinal needle compared to a 24G Sprotte needle with a large side-port. Better mixing of local anesthetics is achieved at the expense of a higher sensitive Mock level.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The Brussels sedation scale: Use of a simple clinical sedation scale can avoid excessive sedation in patients undergoing mechanical ventilation in the intensive care unit

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Analgesic anesthesia with fentanyl (F) and sufentanil (SF) in coronary surgery. A double blind study

This study includes 54 unselected coronary patients. 50 underwent one or several aortocoronary bypasses associated with left ventricular resection (3 times), mitral valve replacement (twice) or aortic valve replacement (twice). Four patients underwent left ventricular resection alone. The operations were performed under analgesic anesthesia with sufentanil (SF) or fentanyl (F), with a double blind protocol. The ratio of concentrations of the two analgesics was SF/F = 1/10. Flunitrazepam induced and maintained sleep. After having reached by increments the total dose of 1.5 mg F/M2 or 0.15 mg SF/M2, droperidol was then added in small amounts of 3.75 mg/M2, alternating with the analgesic, both being given as needed to maintain blood pressure between 100 and 120 mm Hg, in order to potentiate the level of analgesia reached and prevent vasoconstriction. Under this setting, tachycardia (heart rate > 100 beats/min, and < 120 beats/min) was observed before ECC in only 7.4% of the cases with both analgesic and brief episodes of hypertension (mean maximum systolic blood pressure was 140.7 ± 20.3 mm Hg seen with SF, exclusively). There was neither postoperative hypertension (except with 6 out of the 7 known hypertensive patients) nor low caridac output, nor arhythmia. No patients remained in intensive care unit more than 24 hours. No difference attributable to the used analgesic was detectable in the early and late follow-up in both series. On an average, the patients were discharged on postoperative day 10 in a valid condition.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Open source patient data management system for intensive care

In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management System (PDMS). To respond to the needs of a Surgical Intensive Care Unit, we developed a PDMS based on open source software and components. The software was designed as a client-server architecture running on the Linux operating system and powered by the PostgreSQl data base system. The client software was developed in C. The application offers the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications and scoring systems functionalities. The PDMS was used to care more than two thousands patients with the expected reliability and functionalities. © 2007 The authors. All rights reserved.SCOPUS: cp.pinfo:eu-repo/semantics/publishe