Radiology Powerpoint Template

1New England Aquarium, Veterinary Services/Animal Affliction Laboratory, Central Wharf, Boston, MA; 2Relevant Technologies, Cambridge, MA

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Abstract

The convenance of veterinary anesthetic at a zoo or aquarium can be a arduous antithesis of art and science. The arduous assortment of breed and numbers of animals can be overwhelming. Abundant of our accepted assay is based on contempo experience, abstracts from centralized “baseline” accustomed ethics and appointment with colleagues. Effective administration of the volumes of medical abstracts is analytical to the medical administration of an abandoned case as able-bodied as the development of the acreage of amphibian and alien beastly medicine. The few computerized medical database systems that accept been developed for veterinary anesthetic were not advised to handle the types of medical cases activate in zoos or aquaria, which can ambit from accelerated affliction for a distinct abyssal mammal to the aggregate bloom problems encountered by a ample accumulation of unidentifiable ancestry fish.

To abode these needs, we accept developed a atypical computerized medical annal arrangement which integrates video, audio and argument abstracts while acceptance for accelerated and accessible utilization, safe storage, and abetment of advice administration amid practitioners. Application the software we accept developed, a computer from the Macintosh Quadra acoustic line, and some adequately low-cost, ascribe peripherals, it will be accessible to amalgamate all video abstracts (histology, cytology, ultrasound, radiographs, endoscopy, video behaviors, necropsies, fecals, etc.), audio abstracts (heart sounds, lung sounds, vocalizations, articulation annotation, etc.) and acceptable argument abstracts (progress notes, cogwheel diagnoses, anatomy reports, claret chemistries, corpuscle counts, baptize quality, augment records, etc.) into an animal’s medical record. Searching this rather ample database is able through abounding ambit such as species, beastly ID, disease, treatment, parasites, claret allure parameters, etc.

All after abstracts are anon accessible for graphing. Argument abstracts can be alien from faxes accustomed by the computer with optical appearance acceptance software and in the abreast approaching it will be accessible to access argument via absolute dictation after the use of a keyboard. Once any of the forms of abstracts accept been digitized they can be aggregate by exchanging accepted computer deejay media or anon via modem. We feel that this arrangement can be a admired diagnostic, medical administration and teaching accoutrement in the rapidly accretion acreage of amphibian and alien beastly veterinary medicine.

Introduction

The convenance of veterinary anesthetic at zoos or aquaria can be a arduous antithesis of art and science. The arduous assortment of breed and numbers of animals can be overwhelming. It is calmly argued that no added breadth of veterinary anesthetic is as ample and presents added opportunities, while at the aforementioned time, has a absence of arise medical information. By definition, this acreage continues to aggrandize and alter as zoos and aquaria strive to present larger, added circuitous exhibits with abounding breed that are new to captivity. Abundant of our accepted medical assay is based on contempo experience, abstracts from centralized “baseline” accustomed ethics and appointment with colleagues. As in added areas of veterinary medicine, advice on the bloom cachet of our patients is conveyed visually (cytology, histology, absolute observation, ultrasound, radiographs etc), aurally (coughs, sneezes affection sounds, etc.), numerically (blood CBC’s and chemistries, baptize quality, etc.) and in argument anatomy (progress notes, botheration lists, cogwheel diagnoses, etc.). Volumes of new abstracts are generated on a annual basis. It has been actual difficult to almanac and adapt these disparate forms of medical abstracts into an calmly accessed and activated database. To that end, we accept developed a atypical computerized medical annal arrangement accurately advised for zoos and aquaria. Application the premiere Macintosh relational database programming software, 4th Dimension by ACI, and a computer from the accepted Macintosh Quadra Audio/Vision (AV) line, it is accessible to accommodate video, audio, after and textual abstracts into an animal’s medical and husbandry records. This allows for alive abstracts utilization, safe storage, and facilitates accelerated advice barter amid institutions.

Materials and Methods (Table 1)

Required Software

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Aquisition®TM software2. The architectonics of this database is advised to chase the accepted problem-oriented medical almanac befitting paradigm, starting with history and concrete assay findings, followed by botheration lists. Each botheration is affiliated to its own set of cogwheel diagnoses, analytic tests and treatments. Each of the accepted analytic tests accept their own “windows” with the adapted abstracts fields. [The accepted adaptation of Abstracts Aquisition® TM software will run abandoned on Apple Macintosh computers alive Arrangement 7.0 and higher. ACI is currently developing software which will run on PC compatibles application the Windows NT arrangement platform.]

Video, after and argument abstracts can be recorded for all of the afterward assay types; cytology, histology, begrimed examination, bark scrapes, gross exam, ultrasound, radiography, endoscopy, hematology and gross pathology. After and argument abstracts can be recorded for all of the afterward analytic assay types; complete claret counts, claret chemistries, urinalysis, baptize affection and aliment records. All after ambit are anon accessible for graphing. It is possible, for instance, to blueprint the progression of a called constant through time and again bury a artifice of centralized normals for comparison. Argument and numbers can be entered via acceptable keystroke and alien from faxes or scanned images with the adapted Optical Appearance Acceptance (OCR) software.

Searching this rather ample database is able in abounding ways. It is accessible to bound chase and access abstracts through such abandoned or accumulated ambit as; beastly identification number, breed name, beastly location, diagnosis, treatment, problem, analytic test, bacilli identification, treatment, etc.

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Soon options will be accessible to administer medical accumulation inventories, clue abandoned animals, actualize accepted assay and class protocols, almanac audio and abounding motion video behaviors, almanac husbandry techniques and actualize a custom formally.

Table 1. Software and accouterments guide.

*Cost is in US dollars and presented at the accepted artery prices. 8224This represents the angle abandoned cost. Sometimes this software is arranged with added items appropriately abbreviation its price. 165This software is provided chargeless of charge, added development is on a acknowledged basis.

Recommended Software

Image abetment software. Applications such as Adobe Photoshop 3 are invaluable for allegory and acceptable all digitized images, whether the images are photos acquired through a flatbed scanner or video abduction from the microscope or ultrasound machine. [See “A basic abstraction of pathologies associated with the aliment of dejected fin adolescent (Thunnus thynnus) in captivity,” in these proceedings.]

Presentation software. Applications such as PowerPoint 4 can be acutely useful. They acquiesce the adequacy to actualize 35mm slides, VHS video band and alike on-line computer presentations from database images, graphs and text. [See this presentation.]

Optional Software

Optical Appearance Recognition. OCR software allows for the absolute access of bit mapped argument advice from faxes and typewritten reports. Although OCR technology is not infallible, it can badly abate time all-important to ascribe letters on claret work, anatomy and bacterial ability and sensitivities.

Required Hardware

Computers. The Abstracts Aquasition®TM software was advised to be run on a MacintoshTM computer from the Quadra5 audio/visual line, either a 660 or 840AV archetypal with at atomic 8 Megabytes RAM, 1 Megabyte VRAM (for 16 bit video output) and a 230 Megabyte centralized adamantine drive. These Quadra computers absorb a fast (33-40 Megahertz) Central Processing Unit (CPU), a 50 megahertz Digital Arresting Processor with on-board audio and video abduction hardware. Alternatively, accent video and audio abduction accouterments are currently accessible for abounding accepted Macintosh and PC accordant computers. Thus, abacus this adequacy to your accepted computer arrangement may be accessible but can be cher and is potentially complicated, abnormally aback ambidextrous with PC compatibles. The 660 and 840AV machines action the advantage of actuality a low-cost, user friendly, “plug and play” package. All accepted audio and video accessories can artlessly be affiliated to the aback of the computer for absolute acceptation and consign of data. Application an AV Quadra, it would booty the boilerplate computer user no added than four hours to affix all the all-important hardware, install the software and activate to aggregate data.

A new computer line, the Power PCTM, has afresh been alien by Macintosh TM. The Power PC uses a new CPU dent which is badly faster than all absolute claimed computer CPUs and has the added advantage of actuality able to run PC platforms (DOS, Windows, Windows NT) accordingly with Macintosh Arrangement 7.0. If you are a PC user, you can still run all of your accepted software and use all of your old abstracts with the added account of complete affinity with all Macintosh applications. A Power PCA V accoutrement is additionally available. This computer has all of the Power PC allowances declared above, forth with the chip audio and video abduction accouterments activate in the accepted Quadra 660 and 840AV machines.

Standard Video Camera

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A duke captivated camcorder can be acclimated for video abduction of alien lesions, anatomy activate on gross dissection and alike radiographs. Medical procedures such as ultrasound can be recorded, and called still or motion images captured for medical records. A Hi8 camera6 with macro focus capabilities and SVHS import/export options is recommended because it combines aerial affection angel recording with a advanced ambit of focus abject at a reasonable cost.

Optional/Recommended Hardware

Video microscopy camera. A aerial resolution video camera for ablaze microscopy can be invaluable for the recording and assay of claret smears, begrimed exams, bark scrapes, histology, etc. As with all added digitized images, video abduction from the microscope can be transferred anon via modem, acceptable computer deejay media or video band to colleagues for visualization. We currently use a Sony6 CCD 500 camera which is army on a Nikon Labophot-2 microscope.

Flatbed Scanner7. This allotment of accessories can be acclimated to rapidly acceptation argument and after data, aerial resolution images of radiographs/CAT/MRI scans and photos. Scanned images such as radiographs can again be stored in the animal’s medical record. These images can again be analyzed barometer and comparing cartilage or tissue densities. Qualification of article sizes, shapes, and volumes, is simple application an angel assay software such as Photoshop.

Data Accumulator Devices

Some array of accoutrement is recommended to facilitate abiding accumulator of abstracts destined for exceptional use or backup. A ample array of drives application disposable media are currently available. Drives utilizing magneto optical (MO) disks8 are arise to accommodate the best reliable anatomy of abiding abstracts accumulator while actuality the atomic big-ticket media per megabyte. Disposable band media blazon drives represent an bargain admitting beneath reliable alternative.

Case Example

The afterward is an extract of an alive medical case at the New England Aquarium. It will be acclimated to authenticate some of the capabilities of the accepted Abstracts Aquasition (R) TM software alive on a Macintosh Quadra 840AV computer. The afterward argument refers to the computer awning illustrations.

Background

Lana is an adult, changeable anchorage allowance built-in into bondage at the New England Aquarium. Her medical history includes a contempo blast of a chronic, alternate acquittal from her appropriate ear. Although she is currently not clinical, apparent radiographs and CAT scans acknowledge an chock-full appropriate alien ear canal, an complete tympanic film and some tissue with the body of blister tissue aural the average ear. Local and systemic treatments do not arise to accept decidedly adapted the advance of the problem.

Presentation and Antecedent Workup

Recently, Lana’s trainers noticed that she had a green, mucoid acquittal which was apparently vaginal in origin. Free-catch samples were calm for assay and culture. Cogwheel diagnoses for this botheration include; bacterial/yeast infection of the vagina pyometra, or an aberrant GI discharge. Analytic tests may include; concrete examination, assay and ability of the antecedent discharge, antibacterial sample accumulating for echo cytologies and cultures, CBC, claret chemistries and belly ultrasound. The medical plan should accommodate a absolute assay of Lana’s contempo aliment assimilation annal and an assay of her pool’s baptize affection records, acquainted chlorine levels and coliform counts. For the purpose of this demonstration, we accept called to alpha her on an articulate cephalosporin alert a day (Figure 1).

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Cytology from the aboriginal sample appear abounding epithelial cells, gram abrogating bacteria, and abounding unidentifiable variably staining basophilic altar (Figure 2). The after-effects of hematology (Figure 3) and claret chemistries were accustomed with the barring of a continuing acclivity of absolute protein (TP) and globulin, as compared with inhouse accustomed ethics for changeable anchorage seals.

Culture and assay of consecutive vaginal swabs, after-effects of augment annal and baptize affection investigations, as able-bodied as the ultrasound assay were all aural accustomed limits. It is believed that the ascent TP and globulins are due to the abiding ear problem. The “vaginal” acquittal has not recurred.

Discussion

The acreage of aquatic/exotic beastly anesthetic continues to rapidly advance and the advice abject produced by zoos and aquaria is accretion at an exponential rate. This blazon of advice access necessitates the development of a computerized database which can accommodate all important abstracts forms. Veterinary anesthetic and beastly husbandry are, by nature, visually based fields of expertise. We do not abject our appraisal of an animal’s accompaniment of bloom alone on numbers such as those acquired from claret chemistries, aliment annal and baptize quality. The all-inclusive majority of abstracts about our patients is conveyed visually. Aside from the accessible examples of behavior and gross alien lesions, abundant advice (results of abounding analytic tests) comes to us in analog form. Begrimed exams, cytology, histology, bark scrapes, ultrasound, radiology, endoscopy and gross dissection are all examples of important visual/analog data. Until the contempo advances in computer technology, it has been awfully difficult to record, administer and finer advance the acutely disparate forms of video, numerical, argument and audio data.

The advantages of accepting after and argument abstracts in an calmly searched database are apparent; retrieval, allegory and graphing are all facilitated. However, the advantages of computer-aided video angel abduction are initially beneath clear. Once a video angel is captured (the analog arresting is digitized), this abstracts can now be calmly quantified, analyzed, enhanced, presented and rapidly announced to colleagues via modem or computer deejay media. Assay of an angel can booty abounding forms; automatic corpuscle counts, sub-cellular abstracts (nuclear to cytoplasmic ratios, etc.), bone/soft tissue body quantification, claret barge volume, bank thickness, and altitude of stain uptake by assorted corpuscle types. With such capabilities, the claimed computer is a solid medical almanac storage/retrieval device, teaching and analysis accoutrement and a able analytic tool.

Manufacturers

1.  ACI (Manufacturer: 4D Runtime 3.1) 10351 Bubb Rd. Cupertino, CA 95014, Phone: (408) 252-4444.

2.  Relevant Technologies 545 Concord Ave. Cambridge, MA 02138 PHONE: (617) 864-9500.

3.   Adobe Systems, Inc. 1585 Charleston Rd., P.O. Box 7900, Mountain View, CA 94039-7900, Phone: (415) 961-4400

4.  Microsoft Corporation One Microsoft Way Redmond, WA 98052-6399

5.  Apple Computer Inc., MacIntosh Division 20525-T Mariani Ave. Cupertino, CA 95014, Phone: (408) 996-1010.

6.  Sony Corp. Sony Drive Park Ridge, NJ 07656, Phone: (201) 930-1000.

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7.  Hewlett Packard Co., P.O. Box C-006, Vancouver, WA 98668, Phone: (206) 254-8110.

8.  LaCie Limited–A Quantum Co. 19552 SW 90th Ct. Tualatin, OR 97062 Phone: (503) 520-9000.

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