Medical image management

Medical image management is becoming increasingly complex as additional data are produced by equipment using digital techniques. As the requirements to store and display these images increase, the following questions become important: (a) What methods can be used to ensure that information given to the physician represents the originally acquired data? (b) What technology and methods are needed to guarantee that information is presented in a timely fashion when requested? (c) How can an image archiving and transmission system be designed to protect the patient's rights of confidentiality? The authors discuss the legal implications of digital archiving of image information and propose some approaches to designing systems that provide the most information to the physician and yet attempt to minimize infringement of the patient's rights.     

Differences in tidal breathing between infants with chronic lung diseases and healthy controls

Background  

The diagnostic value of tidal breathing (TB) measurements in infants is controversially discussed. The aim of this study was to investigate to what extent the breathing pattern of sleeping infants with chronic lung diseases (CLD) differ from healthy controls with the same postconceptional age and to assess the predictive value of TB parameters.     

Trauma of the extremities: prospective comparison of digital and conventional angiography

Digital subtraction angiography (DSA) and conventional film angiography (CFA) were compared prospectively in 50 patients with trauma of the extremities. Each patient underwent both procedures with comparable imaging parameters and injections. Three angiographers reviewed the angiograms for the presence of seven angiographic signs of arterial injury. The two modalities showed pseudoaneurysms, arteriovenous fistulas, vessel displacement, occlusion, and focal narrowing equally well. CFA was superior to DSA in delineating intimal dissection; DSA was better for demonstrating extravasation. Clinical follow-up demonstrated that both procedures had a sensitivity of 100%; the specificity was 94% for DSA and 97% for CFA. Neither procedure produced a false-negative result.     

Application of Micro- and Nano-Electromechanical Devices to Drug Delivery

Micro- and nano-electromechanical systems (MEMS and NEMS)-based drug delivery devices have become commercially-feasible due to converging technologies and regulatory accommodation. The FDA Office of Combination Products coordinates review of innovative medical therapies that join elements from multiple established categories: drugs, devices, and biologics. Combination products constructed using MEMS or NEMS technology offer revolutionary opportunities to address unmet medical needs related to dosing. These products have the potential to completely control drug release, meeting requirements for on-demand pulsatile or adjustable continuous administration for extended periods. MEMS or NEMS technologies, materials science, data management, and biological science have all significantly developed in recent years, providing a multidisciplinary foundation for developing integrated therapeutic systems. If small-scale biosensor and drug reservoir units are combined and implanted, a wireless integrated system can regulate drug release, receive sensor feedback, and transmit updates. For example, an “artificial pancreas” implementation of an integrated therapeutic system would improve diabetes management. The tools of microfabrication technology, information science, and systems biology are being combined to design increasingly sophisticated drug delivery systems that promise to significantly improve medical care.     

ABDOMINAL SYMPTOMS,HYPERCALCAEMIA AND APATHETIC HYPERTHYROIDISM: TREATMENT WITH PAMIDRONATE

SUMMARY A 24-year-old man with anorexia, repeated bouts of vomiting, and wasting was found to have florid thyrotoxicosis and hypercalcaemia. Pamidronate promptly reduced the serum calcium concentration to normal, and simultaneously abated the abdominal symptoms, which did not recur in spite of continuing severe hyperthyroidism, which was eventually controlled by radioactive iodine ablation of thyroid activity.