Computer-guided cardiological examination and data management with a microcomputer

A computer program is presented apt to be run on a personal computer. The program allows a computer-guided cardiological examination of standard quality, permits a rapid recall of patients data and makes it possible to obtain statistical analyses.     

Analysis of economic data and elaboration of professional guidelines

As medicine becomes increasingly complex, economic constraints are beginning to weight more heavily on the actors of our health system. It follows that one of ANAES' missions is to initiate and promote professional guidelines that take full account of economic arguments. One of the benefits of economic evaluation is to provide professionals with information about the economic consequences of their practices. This implies determining to what extent the methodological principles used to develop clinical guidelines can also apply to the incorporation of economic criteria in professional guidelines. Economic evaluation offers those active in the field of health an information that can be absorbed into the reality of what they actually do in practice. Professionals can thus orient themselves towards practices which have not only been clinically validated but are also cost-effective. This is the objective that underlies the critical appraisal of economic evaluation publications. Such appraisals help professionals to base their choices on objective grounds.     

Angiocardioscintigraphy in the cardiological surveillance of chemotherapy with anthracyclines]

Equilibrium angiocardioscintigraphy is a noninvasive nuclear medical method which allows cardiac function to be assessed. It is widely used in oncology since some clinically important drugs used in antitumor chemotherapy have a marked cardiotoxic effect. Angiocardioscintigraphy enables several parameters characteristic of cardiac function to be assessed, namely the left ventricular ejection fraction whose alterations during chemotherapy allow possible cardiotoxic side effects to be revealed before the development of irreversible heart failure.     

Applied cardiological research. Challenges for the new millenium

Poor eating habits, a sedentary life style, and smoking have made acute coronary syndrome a disease characteristic of modern life. Although the widespread appearance of coronary heart disease has been delayed by 10 years, it is expected to be the primary cause of death in the world by the year 2020, in spite of the development of reperfusion therapy and the use of defibrillators. The incidence of coronary heart disease is spreading to more depressed areas and affecting an increasingly larger number of persons over 70, who are generally poorly represented in clinical studies and respond less favorably to treatment. Detaining the advance of this epidemic demands the development of a competitive research policy that includes rigorous training of researchers and scientific programs based on cooperation and teamwork. The success of this scientific strategy rests on public and private fund-raising to finance the anticipated priority areas of cardiovascular research in the coming years: vascular immunobiology, genome studies, tissue transplantation, and organogenesis. Advances in research complemented by the implementation of preventive measures based on a unified scientific approach and community educational campaigns could act effectively against the spread of cardiovascular disease in the world, thus avoiding otherwise inevitable social and economic consequences.     

Medical progress and rationing of cardiological services

Summary Due to the financial restrictions imposed on all national health services, the problem of allocating medical resources has gained new economical and political dimensions. Although each patient expects optimal treatment, the rationing of medical services make it increasingly difficult to provide the most adequate therapy. Health politicians and medical doctors have all advocated that health expenditures can be reduced by effective prevention of coronary heart disease, one of the main cost factors for all health services. Due to the introduction of statins, primary and secondary prevention of coronary heart disease can now be accomplished effectively. However, such treatment does not induce cost reduction, but rather an increase in costs. This applies predominantly to primary prevention. Treatment of all who would benefit from lipid lowering by statins would be prohibitively expensive for all national health care systems.