SummaryObjectives: To analyze the attitude of physicians towards alerting in CPOE systems in different hospitals in different countries, addressing various organizational and technical settings and the view of physicians not currently using a CPOE.Methods: A cross-sectional quantitative and qualitative questionnaire survey. We invited 2,600 physicians in eleven hospitals from nine countries to participate. Eight of the hospitals had different CPOE systems in use, and three of the participating hospitals were not using a CPOE system.Results: 1,018 physicians participated. The general attitude of the physicians towards CPOE alerting is positive and is found to be mostly independent of the country, the specific organizational settings in the hospitals and their personal experience with CPOE systems. Both quantitative and qualitative results show that the majority of the physicians, both CPOE-users and non-users, appreciate the benefits of alerting in CPOE systems on medication safety. However, alerting should be better adapted to the clinical context and make use of more sophisticated ways to present alert information. The vast majority of physicians agree that additional information regarding interactions is useful on demand. Around half of the respondents see possible alert overload as a major problem; in this regard, physicians in hospitals with sophisticated alerting strategies show partly better attitude scores.Conclusions: Our results indicate that the way alerting information is presented to the physicians may play a role in their general attitude towards alerting, and that hospitals with a sophisticated alerting strategy with less interruptive alerts tend towards more positive attitudes. This aspect needs to be further investigated in future studies.

Abstract— Intravenous injection of a sonicated dispersion of bovine brain phospholipids results in a significant change in both NaF‐dependent and dopamine dependent adenylate cyclase activity. High dosage of phospholipids inhibits the dopamine dependent, but not the NaF dependent, adenylate cyclase activity. The stimulation of cyclase activity is accompanied by an increased level of cAMP in mice brains. Treatment with haloperidol abolishes the increase in cAMP. Among individual phospholipids, phosphatidylserine is the most active component for inducing the activation of DA‐dependent adenylate cyclase activity.

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Twelve patients, intubated for acute exacerbation of chronic obstructive pulmonary disease, received six intravenous doses of 400 mg of pefloxacin at 12-h intervals. Samples of blood and bronchial secretions were taken simultaneously, before the injection and at 0.5, 3, 6, 9, and 12 h after the end of the sixth infusion. There was a large variation in pefloxacin levels in both serum and bronchial secretions. The mean concentrations of pefloxacin in bronchial secretions ranged from 6.51 to 11.1 ,ug/mI and were higher than the corresponding concentrations in serum at all times. Of 61 bronchial specimens, 48 (79%) contained more than 8 ,ug of the antibiotic per ml.Pefloxacin is a new synthetic antibiotic derived from quinolinecarboxylic acid. In vitro, this drug has excellent activity against a wide range of bacterial species, including especially most members of the family Enterobacteriaceae, staphylococci, and Pseudomonas spp. (3,5,11). Most strains of these organisms are susceptible to concentrations equal to or less than 2 ,ug of the antibiotic per ml, except for Pseudomonas spp. (4 to 8 ,ug/ml).Since these organisms are frequently isolated from tracheal cultures of patients who require endotracheal intubation and mechanical ventilation (13), we undertook a study of pefloxacin penetration into the bronchial secretions of intubated patients.Twelve patients who required endotracheal intubation and mechanical ventilation because of acute respiratory failure were enrolled in this study. All of the patients studied, nine men and three women, had an acute exacerbation of chronic obstructive pulmonary disease. Their ages ranged from 38 to 73 years (mean, 65.9 years), and body weights ranged from 46 to 104 kg (mean, 62 kg). The apparent cause of acute respiratory failure in all patients was purulent tracheobronchitis, evidenced by the production of purulent bronchial secretions without radiologic features of pneumonia. At the time of the study, all patients were clinically stable, with plasma creatinine and routine biochemical liver function tests within the normal limits. All patients received intensive physiotherapy and a mucolytic agent, bromhexine (4 mg three times a day). All patients gave their informed consent to inclusion in the study. The samples were collected after the administration of six doses of 400 mg of pefloxacin, when the steady state was probably reached. Each dose was given at 12-h intervals as a 1-h intravenous infusion. Venous blood and bronchial secretion samples were taken simultaneously, immediately before the injection and at 0.5, 3, 6, 9, and 12 h after the end of the sixth infusion. Bronchial secretions, obtained with a suction catheter inserted into the endotracheal tube, were homogenized with pancreatin. All of the samples were stored at -40°C until assayed.In all patients, pefloxacin concentrations were measured in plasma and bronchial secretions by using a microbiologi- Good correlation was observed between the values obtained in serum and bronchial secretions, by both highperformance l...

BackgroundThe Catalog and Index of French-language Health Internet resources (CISMeF) is a quality-controlled health gateway, primarily for Web resources in French (n=89,751). Recently, we achieved a major improvement in the structure of the catalogue by setting-up multiple terminologies, based on twelve health terminologies available in French, to overcome the potential weakness of the MeSH thesaurus, which is the main and pivotal terminology we use for indexing and retrieval since 1995. The main aim of this study was to estimate the added-value of exploiting several terminologies and their semantic relationships to improve Web resource indexing and retrieval in CISMeF, in order to provide additional health resources which meet the users’ expectations.MethodsTwelve terminologies were integrated into the CISMeF information system to set up multiple-terminologies indexing and retrieval. The same sets of thirty queries were run: (i) by exploiting the hierarchical structure of the MeSH, and (ii) by exploiting the additional twelve terminologies and their semantic links. The two search modes were evaluated and compared.ResultsThe overall coverage of the multiple-terminologies search mode was improved by comparison to the coverage of using the MeSH (16,283 vs. 14,159) (+15%). These additional findings were estimated at 56.6% relevant results, 24.7% intermediate results and 18.7% irrelevant.ConclusionThe multiple-terminologies approach improved information retrieval. These results suggest that integrating additional health terminologies was able to improve recall. Since performing the study, 21 other terminologies have been added which should enable us to make broader studies in multiple-terminologies information retrieval.