KEYWORDS: Decision support systems, Surgery, Spine, Pathology, Medicine, Databases, Safety, Information technology, Systems modeling, Picture Archiving and Communication System
Using of Decision Support System (DSS) in medicine affects the improvement of health care quality by means of increasing accuracy and specificity of diagnostics, customization of medical care, decreasing sequelae and terms of patients’ rehabilitation. DSS are using for proving of treatment efficacy and safety and let reduce personnel labour efforts. In this regard developing of DSS requires studying the needs of orthopedic surgeons as key users of such systems. Aim of this study performed at the base of 2 university medical centers in Saratov and Nizhny Novgorod which fulfill about 10% of surgeries in Russia concerning spine-and-pelvic complex pathology) deals with discovering the needs of orthopedic surgeons about desired DSS functionality by means of using the specially designed questionnaire. Results of the study determine following DSS functionality: use of geometric planning and biomechanical modeling before the surgery; surgery fate prognosis at the base of clinical and X-ray success criteria; ability to design the individual implants; integration of DSS with PACS and often using medical informational systems.
Preoperative planning systems (PPS) currently are very important for evidence-based medicine promotion in surgery worldwide. Design and development of such systems is the mainstream of health care provision in Russia and let to apply preventive, diagnostic and remedial technologies based on the evidenced effectiveness and safety. PPS allow to reduce planning time, increase its accuracy and to minimize medical malpractice. Modern PPS perform a geometric planning helping surgeon to make the correct decision regarding surgery management. Special PPS designed for vertebral-pelvic complex surgery allow evaluate bone and joint deformation degree, planning simultaneous implants replacement, osteotomy. The evaluation is based on 2D and 3D medical images (if available) studying. The analysis of the most demanded modern PPS (MediCad, TraumaCad, OrthoView and Surgimap) properties shows that all of these products allow to measure a massive number of orthopedic parameters: scoliosis, lordosis, sagittal balance, the angular deviation of the sacrum, the cervico-diaphyseal angle, the Hilgenreiner angle etc. However not all of indicated systems allow to automatically search such parameters as the Reimer index (percentage) and epiphyseal index. Also not all the systems have the detection of calibration devices function and Auto-Hip function. So the aim of this study is to identify and prove the sufficient number of parameters to be evaluated by the surgeon to perform correct geometric preoperative planning in vertebral and pelvic complex surgery.
KEYWORDS: Biomedical optics, Medical devices, Pathogens, Bacteria, In vitro testing, Scanning electron microscopy, Microorganisms, Crystals, Medical research, Electron microscopy
The current study was designed to investigate the dynamics of microbial biofilm-formation in standard and clinical strains of uropathogenic Escherichia coli (UPEC), using spectrophotometric and electron microscopic methods. For achieving this goal, three E. coli strains were used (one standard and two clinical). These isolates differ in the existence of fimH virulence gene. The process involved the using of electron microscopy and immunological microtitration plates under in vitro conditions for 96 hours. We found that standard and clinical strains of E. coli were capable of forming a microbial biofilm in vitro, with a higher intensity related to the clinical strain E. coli 245. The using of scanning electron microscopy confirmed the obtained results. The combined use of different optical methods gives a complete characterization of film-forming ability of pathogenic microorganisms.
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