__ I U Letters are welcomed and will be published, if found suitable, as space permits. The editors reserve the right to edit and abridgeletters, to publish replies, and to solicit responses from authors and others. Letters should be submitted in duplicate, double-spaced (including references), and generally should not exceed 400 words.
Consumer Health Information System Urged Today medical professionals are cognizant of the increasing importance of medical information systems. In fact, rapid retrieval from such computerized informational systems often spells the difference between life and death. Such medical information systems have been designed to fill the informational needs of the physician. While this is of critical importance to our health care system, it is, in my opinion, incomplete. Currently there are no provisions within our system for the consumer of health care. Even the National Library of Medicine has no systematic means of providing health data to the average consumer. To help complete our health care system, I suggest the establishment of a public health information system. The rationale for such a national public health information system is based upon my experience as a medical librarian. A medical library receives numerous requests daily from the public for health information; unfortunately the time it takes to answer these questions is usually prohibitive. The recent swine flu debacle along with the rising number of malpractice suits have served to exacerbate the basic problem: the physician has little time or patience to artfully explain the nature of a problem to the satisfaction of his patient; yet informational obligations of the physician to his patient are paramount in any preventive approach to medicine. A computer-based health informa874
Letters to the Editor tion system parallel to MEDLARS could help alleviate this problem by optimizing the informational skills of the physician and providing the consumer with a comprehensible as well as a reliable source of health and medical information. Stage one would be to itemize the criteria for inclusion. Among the criteria must be the screening of all documents by a physician or panel of physicians. Perhaps physicians in collaboration with writers could prepare articles for the public as a supplement to their own practice or even rewrite review articles from medical journals. These writings might include nutritional information, fact sheets on a disease, or story-level information for children. The materials should be intelligible at variant levels of education to insure understanding. The next stage would be to input the selected data into a central computer base so that the system would work along with MEDLAR requests. This necessitates the screening of information in order to make some directly available to the consumer and some available only by a physician's prescription. This can be easily accomplished by coding the data as it is input into the system. As for cost, the system would eventually not only pay for itself, but become a possible source of revenue for the federal government. This proposal presupposes that an informed individual is vital in the establishment of a preventive approach to medicine and suggests that an organized clearinghouse be established to bring under control the current disarray of patient education materials. Who will initiate the design of such a system, and who will implement it? Cathy L. Schell Instructor
University of Miami School of Medicine Miami, FL
with thanks to Paul Rothman of Community Action Research, Miami, FL
Detection of Viral Genes and Core Proteins of Flavoviruses in Human Blood Specimens We have developed a sensitive method for the detection of viral genes and core proteins of flavoviruses (group B arboviruses) in human blood specimens. The method is based on the hydrophobic character of the lipidcoated core surface, which allows the envelope protein-deprived cores to be selectively extracted into ether.' For this purpose, the blood samples, containing traces of the nonionic detergent Tween 80, are shaken with successive portions of ether at 0°C. The ether phase is clarified by low-speed centrifugation and evaporated in vacuo at 040C. The residue is characterized by immunodiffusion analysis, by translation assay in a wheat germ system and, when desirable, by autoradiographic translation product analysis, combining these methods.25 For obtaining preparations of disrupted cores for in vitro translation, the ether should contain traces of H202 and ethanol.24 Any remaining peroxide is subsequently eliminated by excess dithiothreitol. The investigated material included serum of a patient with acute tickborne encephalitis7 with a complementfixing antibody6 titer of 8, serum of the same patient 23 days later when the titer was 256, serum as well as packed blood cells homogenate of a normal healthy person previously vaccinated with 17D live yellow fever vaccine, plasma of 13 normal healthy Swedish subjects between 21 and 36 years of age, and standard yellow fever virus (17D) propagated in leukosis-free chick AJPH September, 1977, Vol. 67, No. 9
Consumer Health Information System Urged Today medical professionals are cognizant of the increasing importance of medical information systems. In fact, rapid retrieval from such computerized informational systems often spells the difference between life and death. Such medical information systems have been designed to fill the informational needs of the physician. While this is of critical importance to our health care system, it is, in my opinion, incomplete. Currently there are no provisions within our system for the consumer of health care. Even the National Library of Medicine has no systematic means of providing health data to the average consumer. To help complete our health care system, I suggest the establishment of a public health information system. The rationale for such a national public health information system is based upon my experience as a medical librarian. A medical library receives numerous requests daily from the public for health information; unfortunately the time it takes to answer these questions is usually prohibitive. The recent swine flu debacle along with the rising number of malpractice suits have served to exacerbate the basic problem: the physician has little time or patience to artfully explain the nature of a problem to the satisfaction of his patient; yet informational obligations of the physician to his patient are paramount in any preventive approach to medicine. A computer-based health informa874
Letters to the Editor tion system parallel to MEDLARS could help alleviate this problem by optimizing the informational skills of the physician and providing the consumer with a comprehensible as well as a reliable source of health and medical information. Stage one would be to itemize the criteria for inclusion. Among the criteria must be the screening of all documents by a physician or panel of physicians. Perhaps physicians in collaboration with writers could prepare articles for the public as a supplement to their own practice or even rewrite review articles from medical journals. These writings might include nutritional information, fact sheets on a disease, or story-level information for children. The materials should be intelligible at variant levels of education to insure understanding. The next stage would be to input the selected data into a central computer base so that the system would work along with MEDLAR requests. This necessitates the screening of information in order to make some directly available to the consumer and some available only by a physician's prescription. This can be easily accomplished by coding the data as it is input into the system. As for cost, the system would eventually not only pay for itself, but become a possible source of revenue for the federal government. This proposal presupposes that an informed individual is vital in the establishment of a preventive approach to medicine and suggests that an organized clearinghouse be established to bring under control the current disarray of patient education materials. Who will initiate the design of such a system, and who will implement it? Cathy L. Schell Instructor
University of Miami School of Medicine Miami, FL
with thanks to Paul Rothman of Community Action Research, Miami, FL
Detection of Viral Genes and Core Proteins of Flavoviruses in Human Blood Specimens We have developed a sensitive method for the detection of viral genes and core proteins of flavoviruses (group B arboviruses) in human blood specimens. The method is based on the hydrophobic character of the lipidcoated core surface, which allows the envelope protein-deprived cores to be selectively extracted into ether.' For this purpose, the blood samples, containing traces of the nonionic detergent Tween 80, are shaken with successive portions of ether at 0°C. The ether phase is clarified by low-speed centrifugation and evaporated in vacuo at 040C. The residue is characterized by immunodiffusion analysis, by translation assay in a wheat germ system and, when desirable, by autoradiographic translation product analysis, combining these methods.25 For obtaining preparations of disrupted cores for in vitro translation, the ether should contain traces of H202 and ethanol.24 Any remaining peroxide is subsequently eliminated by excess dithiothreitol. The investigated material included serum of a patient with acute tickborne encephalitis7 with a complementfixing antibody6 titer of 8, serum of the same patient 23 days later when the titer was 256, serum as well as packed blood cells homogenate of a normal healthy person previously vaccinated with 17D live yellow fever vaccine, plasma of 13 normal healthy Swedish subjects between 21 and 36 years of age, and standard yellow fever virus (17D) propagated in leukosis-free chick AJPH September, 1977, Vol. 67, No. 9
