RESUMO
Communication between different institutions which are responsible for the treatment of the same patient is of outstanding significance, especially in the field of tumor diseases. Regional electronic patient records could support the co-operation of different institutions by providing ac-cess to all necessary information whether it belongs to the own institution or to a partner. The Department of Medical Informatics, University of Heidelberg is performing a project in co-operation with the Thoraxclinic-Heidelberg and the Department of Clinical Radiology, University of Heidelberg with the goal: to define an architectural concept for interlinking the electronic patient record of the two clinical institutions to build a common virtual electronic patient record and carry out an exemplary implementation, to examine composition, structure and content of medical documents for tumor patients with the aim of defining an XML-based markup language allowing summarizing overviews and suitable granularities, and to integrate clinical practice guidelines and other external knowledge with the electronic patient record using XML-technologies to support the physician in the daily decision process. This paper will show, how a regional electronic patient record could be built on an architectural level and describe elementary steps towards a on content-oriented structuring of medical records.
Assuntos
Registro Médico Coordenado/métodos , Sistemas Computadorizados de Registros Médicos/organização & administração , Neoplasias , Linguagens de Programação , Segurança Computacional , Alemanha , Humanos , Sistemas de Informação/organização & administração , Neoplasias/diagnóstico , Neoplasias/terapia , Guias de Prática Clínica como Assunto , Programas Médicos Regionais , Integração de SistemasRESUMO
A screening method for 70 psychoactive drugs or drug metabolites in human serum by solid-phase extraction with subsequent high-performance liquid chromatography and electrospray ionization mass spectrometry was developed. Enhanced selectivity of detection was obtained by collision-induced dissociation using two different skimmer voltages for the individual scan. The mass spectra and the retention times of the compounds were incorporated into a self-generated spectra library for identification in screening experiments. The detection limits were found to be between 0.1 and 5 ng/mL serum for the majority of the compounds when measured in the selected ion mode. Because of the very small serum concentrations and the rather low extraction yield, lysergide could not be detected in this way. It was demonstrated with 140 serum samples from alcohol-related traffic cases that this method is suitable for a routine screening in a forensic laboratory.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Testes Obrigatórios/métodos , Psicotrópicos/sangue , Espectrometria de Massas por Ionização por Electrospray/métodos , Detecção do Abuso de Substâncias/métodos , Acidentes de Trânsito/legislação & jurisprudência , Humanos , Testes Obrigatórios/legislação & jurisprudência , Sensibilidade e EspecificidadeRESUMO
Based on the results of GC-MS analysis, an HPLC procedure was developed for the determination of coumarin, dihydrocoumarin, melilotic acid (o-dihydrocoumaric acid), methyl melilotate, ethyl melilotate, 5-hydroxymethylfurfural and o-coumaric acid which are characteristic compounds of tonka beans. The presence of melilotic acid and ethyl melilotate in tonka beans has not been reported previously. Following HPLC analysis of tonka bean extracts produced in the laboratory and one sample of commercially available tonka bean absolute, evidence was provided that solvents used for production are decisive for the kind and amount of the compounds detected.