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Twenty years ago, the main sources for physicians seeking information on new procedures, drugs, or devices were meetings and medical journals. The dawn of the Internet radically transformed how news and information is delivered and absorbed, beginning with the launch of online journals back in the mid-1990s. A decade and a half later, physicians can learn about new innovations the moment they are made public, and they can get that news from their phones and tablets, their Twitter or Facebook accounts, or via their favorite blog or medical news web site. Along with the clear advantages of accessing new medical information any time of day comes the need for physicians to be aware of the pitfalls of online medical content and to have a heightened sense of responsibility when it comes to integrating information gleaned online into their medical practices.

In the rapid change of drug scenarios, as the powerful development in the drug market, particularly in the number and the kind of the compound available, Internet plays a dominant role to become one of the major "drug market". The European Commission funded the Psychonaut Web Mapping Project (carried out in the time-frame January 2008-December 2009), with the aim to start/implement an Early Warning System (through the data/information collected from the Web virtual market), to identify and categorise novel recreational drugs/psychoactive compounds (synthetical/herbal drugs), and new trends in drug use to provide information for immediate and prevention intervention. The Psychonaut is a multi-site research project involving 8 research centres (De Sleutel, Belgium; University of Hertfordshire School of Pharmacy, St George's University of London, England; A-klinikkasäätiö, Finlandia; Klinik für Psychiatrie und Psychotherapie, Germany; Assessorato Salute Regione Marche, Italy; Drug Abuse Unit, Spain; Centre of Competence Bergen Clinics Foundation, Norway) based in 7 European Countries (England, Italy, Belgium, Finland, Germany, Spain, Norway).

Purpose: E-learning, an abbreviation of electronic learning, indicates the provision of education and training on the Internet or the World Wide Web. The impact of networks and the Internet on radiology is undoubtedly important, as it is for medicine as a whole. The Internet offers numerous advantages compared with other mass media: it provides access to a large amount of information previously known only to individual specialists; it is flexible, permitting the use of images or video; and it allows linking to Web sites on a specific subject, thus contributing to further expand knowledge. Our purpose is to illustrate the regulatory aspects (including Internet copyright laws), current radiological applications and future prospects of e-learning. Our experience with the installation of an e-learning platform is also presented., Materials and Methods: We performed a PubMed search on the published literature (without time limits) dealing with e-learning tools and applications in the health sector with specific reference to radiology. The search included all study types in the English language with the following key words: e-learning, education, teaching, online exam, radiology and radiologists. The Fiaso study was referred to for the regulatory aspects of e-learning., Results: The application of e-learning to radiology requires the development of a model that involves selecting and creating e-learning platforms, creating and technologically adapting multimedia teaching modules, creating and managing a unified catalogue of teaching modules, planning training actions, defining training pathways and Continuing Education in Medicine (CME) credits, identifying levels of teaching and technological complexity of support tools, sharing an organisational and methodological model, training the trainers, operators' participation and relational devices, providing training, monitoring progress of the activities, and measuring the effectiveness of training. Since 2004, a platform--LiveLearning--has been used at our university: this is a Web-oriented application, that is, an Internet software solution that users can access through a Web browser. The pages displayed by the browser are dynamically generated through interaction with a database that collects both data required for the application to work and data related to the courses provided. There are different approaches to developing applications that use databases to store information. The selected approach is based on a modular three-level architecture divided into presentation level, intermediate level, and data level. The LiveLearning platform includes modules to manage multimedia contents and to interface with the streaming server so that the student can access the training contents directly from the platform interfaces. Furthermore, the platform offers its users different modules: Teaching Units, Documents, Forums, and Chats. By appropriately combining these modules, customised training can be devised based on specific requirements., Conclusions: The increasing diffusion of continuous education will reduce the costs of e-learning and make this training method, which helps keep pace with technological progress, more attractive, with significant professional gains for radiologists.

Purpose: The purpose of this article is to illustrate a case where acquisition of digital imaging know-how by a modern radiotherapy division has helped to solve a technical problem while allowing substantial savings through the use of free and open-source resources. The problem was related to the necessity to route, with complex policies, the images produced by different digital imaging and communications in medicine (DICOM) sources within the department or in other divisions and/or hospitals., Materials and Methods: The problem was solved by using completely free, well-tested and stable technologies (PHP, Apache, MySQL, DCMTK OFFIS, Red Hat Linux 9A and Linux Fedora Core 4) and low-cost hardware to contain costs. In the development, we also considered integration of the routed images with the existing electronic clinical records., Results: The system developed, called the dicom router, implemented two kinds of routing: manual and automatic, both oriented to link the images acquired with the existing electronic clinical records. System stability was enhanced in a second phase by using a low-cost hardware redundancy solution. The system has now been operating for 1 year and has proved the value of the technologies used., Conclusions: The need to operate with more than one provider creates a series of integration issues, so that it becomes economically appealing to acquire internally the knowledge needed to interact more precisely with providers of big information technology (IT) solutions. This need is well catered for by open-source technologies, which are well documented and available to everyone. By using them, in-house IT technicians are able to implement valuable technical solutions for small-to medium-sized informatization problems, which would otherwise remain unsolved except with great economic efforts.

The internet is a communication medium and content distributor that provide information in the general sense but it could be of great utility regarding as the search and retrieval of biomedical information. Search engines represent a great deal to rapidly find information on the net. However, we do not know whether general search engines and meta-search ones are reliable in order to find useful and validated biomedical information. The aim of our study was to verify the reproducibility of a search by key-words (pediatric or evidence) using 9 international search engines and 1 meta-search engine at the baseline and after a one year period. We analysed the first 20 citations as output of each searching. We evaluated the formal quality of Web-sites and their domain extensions. Moreover, we compared the output of each search at the start of this study and after a one year period and we considered as a criterion of reliability the number of Web-sites cited again. We found some interesting results that are reported throughout the text. Our findings point out an extreme dynamicity of the information on the Web and, for this reason, we advice a great caution when someone want to use search and meta-search engines as a tool for searching and retrieve reliable biomedical information. On the other hand, some search and meta-search engines could be very useful as a first step searching for defining better a search and, moreover, for finding institutional Web-sites too. This paper allows to know a more conscious approach to the internet biomedical information universe.

Law is more and more implicated in bioethical issues, as demonstrated by the creation of the word "biolaw". One of the most evident aspects of this discipline lies in the extensive production of documents of different kind and provenance (national laws, EU and international regulations). Hence the necessity and interest of collecting this material, for the purpose of facilitating researches on one or more biolaw issues. For this reason a Centre of Biolaw Documentation has been created by the Catholic University of the Holy Hearth, Institute of Bioethics, Rome, Italy. It has the purpose of collecting and cataloguing legal documents, of every kind and geographical provenance, concerning various bioethical issues.

The production of data from oncological research must follow specific steps linked to the type of research carried out. Research can be subdivided into the following areas: translational research, clinical research (Phases I, II and III), pharmacoutilization research, meta-analysis, and guidelines. A topic for discussion is represented by levels of evidence (LOE) of research, considered necessary for the transferral of therapeutic approaches to clinical practice. These involve production times of scientific research, and, in particular, the end-points deemed necessary by the appropriate regulatory bodies to permit the commercialization of drugs (problem of surrogate end-points). The interrelation between researchers and pharmaceutical companies has also recently become an object of reflection and research to find solutions that will guarantee both the independence of research and the legitimate needs of companies. A particularly important issue is the correct transmission of scientifically relevant data to the public by mass media sources. The communication of therapeutic advances obtained through research and scientific innovations should not lead to unrealistic expectations in the general population, which rather serve to weaken the already fragile relationship between the official world of oncology and the diverse universe of patients and their families.

The article describes the main features of the website SIBIL (Sistema Informativo per la Bioetica In Linea) implemented within the framework of a research project of the ISS for collecting, indexing and disseminating Italian literature on bioethics since 1995 through an integrated electronic system. The site, addressed to a wide range of people interested at different degrees and levels in bioethics, offers a comprehensive overview of the activities, such as courses and meetings, on the major ethical issues at stake in Italy, as well as a survey of the most important activities both at national and international level. The main feature of SIBIL is a database of a large collection of documents retrieved through sources or exploitation of the most important international electronic databases. A thesaurus of 1,600 terms, available in Italian and English, was created in order to organize documents with standardized criteria currently adopted in the Italian scientific environment. Future trends of the website are also discussed for sharing experiences with other countries and laying the basis for a European portal on bioethics.

In Italy, as well as in the European Union, there is an increasing need for a common forum on ethics within scientific research. As regards the pivot issue of science governance, a central point of collection and standardization of the variety of different Italian scientific research and bioethics environments is desirable. A focal point of collaboration and discussion, and a credited site for information handling and spreading are also wellcome. The Consiglio Nazionale delle Ricerche website on Bioethics is conceived with these purposes, in order to restore the scientific community role in science public understanding, scientific policy counselling, and boost the processes of communication, value-sharing and social strengthening, which are useful for material and spiritual development of our country.

The Institute of Theory and Techniques of the Legal Information (ITTIG) of the Italian National Research Council (CNR) has produced various electronic information systems. Among these, the archive BIG (Bibliography on right to life and interruption of pregnancy, bioethics and genetic engineering). The article presents the archive BIG in its previous version in print and Internet versions, and it describes its main characteristics (original, analytical, objective, scientific). At last, it exposes the rules for data selection and the debate about the right to life in Italy. The archive BIG enables the expert as well as the layman, to exercise an effective control on the enormous material published on this matter.

Internet represents an essential aid for the professional updating of physicians and researches. Also for the research and therapy in oncology, Internet provides important such as bibliographic data, trials and guidelines with full text, as well as epidemiologic and statistical data. Some of the most authoritative sites are indicated.

The purpose of this paper is to analyze one of the most powerful tools in the decision-making under conditions of uncertainty, the Delphi method, and to verify the related interest of scientific world, particularly, for formulation of guidelines. The method combines the expert opinion preventing biases due to institutional role, status or dominant personality. In the text we explain the methodology and the steps through which it is possible to realize the consensus; we schematized in a didactic manner all the phases for an operational approach of the reader. The search by the most diffused biomedical database (Medline) individualized 623 citations, 7 of which are guidelines (3 of remarkable importance). In conclusion, the Delphi method may be considered particularly interesting for its theoretical assumptions and it can be used as reference tool for assuming decisions in the formulation of clinical practice guidelines as objectively as possible.

The Medline database is now available into a wide number of biomedical websites. Clinicians and scientists can now access the most important bibliographic file in medicine directly from their desktop. Medline availability on the Internet can enhance effectiveness and efficiency of medical activities. Real usefulness of Medline and other databases stands on the relevance and validity of the information content that can be obtained at the least work (and cost) for the user. In order to retrieve really useful information, knowledge of some methodological issues related to bibliographic searching is mandatory to the final user. The rising number of Medline providers on Internet occurring during 1996 and 1997 is a proof that the "ideal" world-wide-Medline has not arrived yet.

Evidence-based Medicine is a product of the electronic information age and there are several databases useful for practice it--MEDLINE, EMBASE, specialized compendiums of evidence (Cochrane Library, Best Evidence), practice guidelines--most of them free available through Internet, that offers a growing number of health resources. Because searching best evidence is a basic step to practice Evidence-based Medicine, this second review (the first one has been published in the issue of March 1998) has the aim to provide physicians tools and skills for retrieving relevant biomedical information. Therefore, we discuss about strategies for managing information overload, analyze characteristics, usefulness and limits of medical databases and explain how to use MEDLINE in day-to-day clinical practice.

It is well-known that while RIS allows the management of all input and output data of a Radiology service, PACS plays a major role in the management of all radiologic images. However, the two systems should be closely integrated: scheduling of a radiologic exam requires direct automated integration with the system of image management for retrieval of previous exams and storage of the exam just completed. A modern information system of integration of data and radiologic images should be based on an automated work flow management in al its components, being at the same time flexible and compatible with the ward organization to support and computerize each stage of the working process. Similarly, standard protocols (DICOM 3.0, HL7) defined for interfacing with the Diagnostic Imaging (D.I.) department and the other components of modules of a modern HIS, should be used. They ensure the system to be expandable and accessible to ensure share and integration of information with HIS, emergency service or wards. Correct RIS/PACS integration allows a marked improvement in the efficiency of a modern D.I. department with a positive impact on the daily activity, prompt availability of previous data and images with sophisticated handling of diagnostic images to enhance the reporting quality. The increased diffusion of internet and intranet technology predicts future developments still to be discovered.

One of the major and demanding problems in the management of a modern department of Radiology is undoubtedly the organization of a radiologic archive. Its management has been increasingly difficult in last years both for the increase in procedures and the number of radiologic exams. At the Radiology department of UCSC, since some years, this problem has been tackled. Major objectives have been identified in focusing on responsibilities, global management and planning of radiologic film retrieval and archiving integrated with health care activities (scheduling of admissions and exam appointments, reporting, discharge). Based on these assumptions, the archive has been divided into 3 sections, each dynamically integrated with the others. The 3 archives should be integrated with RIS and supported by information technology. RIS is considered the starting point of the process. In fact the system ensures communication to the archiving workstation and to the radiology room of patient admission and consequent execution of the exam which involves image production. This user-friendly procedure enables consistent information between RIS and archiving system and correct association of images to the patient medical report, for subsequent consultation.

In an age when the ever-expanding limits of sciences are requiring an adjustment of moral principles and values, the Bioethics file is an essential tool for those who are in need of updated guidelines on bioethical issues. This database--produced by the Kennedy Institute of Ethics (KIE) in collaboration with the National Library of Medicine (NLM)--is distributed online by different hosts and is also available in print version and on CD-ROM. Structure and contents of the online version of the Bioethics file searchable through MEDLARS are described in details.

We applied the Photo-CD technology to create an electronic image file easy and quick to use to optimize the retrieval of medical images for teaching purposes. We digitized 1,500 slides of diagnostic examinations from the archive of our Institution: the corresponding electronic files were stored on Photo-CD disks. The data relevant to every image were collected and recorded with the help of a relational data-base program. Thus, each user could retrieve the suitable images from the optical disks by a multiple and flexible key-word search. We compared the use of the electronic archive with a traditional hand-based file with the help of 3 teachers committed to prepare a lesson containing 5 slides on different subjects. The use of the electronic image archive corresponded to markedly shorter searching and file updating times. We tried also to assess the capabilites of this filing procedure for image post-processing and for the build-up of self-assessment programs.

The access to nursing literature is not always easy: very often nursing journals are not collected in a central library and nurses do not know what is available, even in their own hospital. A group of nurses decided to organize a work group to systematically read and file on a computer program the articles of some of the most well known Italian (and some foreign) nursing journals, and offer the program to all the nurses interested. The steps of the work are described, together with some of the problems encountered and the main characteristics of the computer program.