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10. Collaborative Patient Centred eHealth

Author

J. Bellon, E. De Clercq, G. De Moor, M. Foulon, J. Van Der Lei and J. Bellon, E. De Clercq, G. De Moor, M. Foulon, J. Van Der Lei

Subjects
Medical informatics--Congresses
Abstract

In Medical Informatics three types of processes play a central role: organizational, patient-related and decision making-related processes. The first type deals with settings, such as a hospital care setting or a primary care setting; the second is related to health and disease (i.e. to patients); the third type of process aims at assisting in decision making and therapy and evolves in the brains of healthcare professionals. Hence, in all domains data, information and knowledge play a key role. As these tree processes evolve, dealing with individuals - patients, doctors and nurses - because of that human factor there are obviously limitations imposed by formalization and standardization. In the past, there have been some unrealistic expectations regardingthe possible contributions of medical informatics to healthcare. However, such contributions appeared to be very modest, to say the least. The same applies to the overly optimistic expectations regarding the introduction of electronic health records. Althugh the technology is widely available, all these developments appear to be far more complex than expected. The need for an improved understanding of the nature of medical knowledge to better serve health remains to be emphasized.

Published
2008

16. Eu2(PO3H)3

Author

Foulon, J. D., primary, Durand, J., additional, Cot, L., additional, Tijani, N, additional, and Rafiq, M., additional

Published
1995
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40. Growth of Yersinia pseudotuberculosis in human plasma: impacts on virulence and metabolic gene expression

Author

Coppée Jean-Yves, Foulon Jeannine, Dillies Marie-Agnès, Schiavo Angèle, Lacroix Céline, Frangeul Lionel, Laurans Caroline, Chauvaux Sylvie, Dessein Rodrigue, Rosso Marie-Laure, Médigue Claudine, Carniel Elisabeth, Simonet Michel, and Marceau Michaël

Subjects
Microbiology, QR1-502
Abstract

Abstract Background In man, infection by the Gram-negative enteropathogen Yersinia pseudotuberculosis is usually limited to the terminal ileum. However, in immunocompromised patients, the microorganism may disseminate from the digestive tract and thus cause a systemic infection with septicemia. Results To gain insight into the metabolic pathways and virulence factors expressed by the bacterium at the blood stage of pseudotuberculosis, we compared the overall gene transcription patterns (the transcriptome) of bacterial cells cultured in either human plasma or Luria-Bertani medium. The most marked plasma-triggered metabolic consequence in Y. pseudotuberculosis was the switch to high glucose consumption, which is reminiscent of the acetogenic pathway (known as "glucose overflow") in Escherichia coli. However, upregulation of the glyoxylate shunt enzymes suggests that (in contrast to E. coli) acetate may be further metabolized in Y. pseudotuberculosis. Our data also indicate that the bloodstream environment can regulate major virulence genes (positively or negatively); the yadA adhesin gene and most of the transcriptional units of the pYV-encoded type III secretion apparatus were found to be upregulated, whereas transcription of the pH6 antigen locus was strongly repressed. Conclusion Our results suggest that plasma growth of Y. pseudotuberculosis is responsible for major transcriptional regulatory events and prompts key metabolic reorientations within the bacterium, which may in turn have an impact on virulence.

Published
2008
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