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LRC Highlights
January - March 2000
• Applications of Evidence-Based Practice
• LRC Outreach Into the Community
• Promoting LRC / Partner Sustainability
• Internet Consultations
• Communications And Information Exchange
• Health Policy Change and Medical Curriculum Reform
• Application of Information Technology, Telemedicine, and Database Information Systems
• Useful Resources and Tips for Info Coordinators
Applications of Evidence-Based Practice
Staff at Maternity House No. 1 in Kurgan, Russia, have been actively working to bring various procedures and protocols (including infection control and pharmacy operations) into accordance with standard guidelines. They have also worked out new general approaches to handling problems with subinvolution of the uterus and lochiometra. With help from the info coordinator, Sergey Kosintsev, physicians were able to resolve a debate about the congenital pathology of the development of the nervous system. Using Medline, the Cochrane Library, and the Internet, Nino Berdzuli of the Women's Wellness Center in
Kutaisi, Georgia has been working on developing practice guidelines for the Center. Using the National
Guideline Clearinghouse (, MatWeb
(, and the American College of Physicians /
American Society of Internal Medicine (, Dr. Berdzuli developed a
guideline on the "Investigation and Managment of Cervical Dysplasia, Human Papillomavirus Infection."
She is next planning to work on developing guidelines for breast cancer screening and management of
benign breast diseases.
Physicians in Dubna hospitals decided against using the flu medications recommended by distributors after the information coordinator at the City Health Department did a search on Medline and determined that they were ineffective. In preparation for the introduction of new Latvian hospital certification standards, Riga Maternity Hospital is working to prepare and implement several new clinical protocols--dealing with maternal and child care. The hospital's information coordinator, Dr. Tereze Veinberga, has been providing information support during this process. Traumatologists at Vladivostok City Hospital No. 2 recently came across a study, which suggests that alendronate sodium, an osteoporosis drug, may be effective in helping to relieve pain and disability associated with vertebral fractures. Staff now expect that use of alendronate therapy will result in significant reductions in the number of days patients will be constrained by bed rest and limited activity due to back pain. Julia Muravievskaya of the Dubna Health Care Department composed and submitted an article to the Electronic Journal on Information Systems in Developing Countries Learning Resource Center (LRC) Project American International Health Alliance (AIHA) ( about her institution's experience with clinical
practice guidelines and evidence-based practice.
Helen Phagava of the National Information Learning Center in Tbilisi, Georgia disseminated the first issue of the Evidence Based Medicine Electronic Bulletin (EBMEB) of Georgia to more than 90 e-mail addresses. A second issue, which included a translation of an article from the New York Times on the Tbilisi Bacteriophage Institute, was distributed in February to over 200 subscribers as well as to Georgian President, Eduard Shevardnadze, who later visited the Institute and promised to support their further research. The NILC has also begun work on the Georgia Health National Database, a cooperative project with the National Health Management Center and the UK Department for International Development (DFID). The project aims to produce an on-line database of healthcare information for the biomedical community in Georgia and interested parties abroad. Staff at Odessa Sea Port Polyclinic in Ukraine are using information obtained through the LRC to prepare reports for physician conferences and to get info on new methods of treatment. Recent examples include reports on (a) treatment and prevention of arterial hypertension and diabetes, (b) short-term and long-term effects of minimally invasive treatment for gastroesophageal reflux disease, and (c) modern treatment of stomach ulcers. In March, a physician at Vanadzor Polyclinic No. 5 in Lori, Armenia, obtained information from the Internet in order to diagnose a patient with cytomegalovirus and was able to find useful treatment information. Using data from the U.K. Prospective Diabetes Study (UKPDS), physicians at Vladivostok City Hospital
No. 2 have begun to implement American Diabetes Association (ADA) recommendations for
management of type 2 diabetes. According to Alexander Dubikov, until about four years ago,
sulphonylureas was the only type of oral anti-diabetic agent available on the market. Once patients failed
this therapy, the only pharmacological alternative was insulin treatment. Today, there are multiple options
for initial monotherapy, as well as combination therapy, which are successful in improving blood glucose
control. Besides the obvious advantage to combination therapy, in terms of possible additive or
synergistic effects to reduce blood glucose levels, there is an additional important concept that emerges
from the availability of multiple drugs: the concept of mechanism-specific treatments. Further
information about the recommendations can be found at
Thanks to information from the Internet, physicians at Odessa Oblast Hospital in Ukraine have learned about new methods of endoscopic treatment for choledocholithiasis, and they are now beginning to use these methods in the hospital. Andrei Ureche, information coordinator at Republican Clinical Hopsital in Chisinau, Moldova, reports
that he has recently been receiving a lot of requests for guidelines and algorithms from the US (on
cardiology, surgery, etc.), and that these guidelines are being successfully applied at the hospital. In
March, for example, physicians adopted new guidelines for treating ischemic heart disease, which they
found at the Web site of the European Society of Cardiology (
During the height of the flu epidemic in Bishkek, physicians at the Institute of Obstetrics and Pediatrics acquainted themselves with the different measures and treatments used around the world to prevent transmission of the flu virus. This information was disseminated widely among nurses in the neurology department, and as a result staff and patients from this department have not experienced a single case of the flu so far. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) Using resources from the Internet, Tibor Baska of the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia, has designed an epidemiological survey for evaluating behavioral differences associated with ethnicity and culture. The survey helps to determine how various behavioral features are linked to important risk factors of cardiovascular and oncological diseases. Antonina Goryunova from the LRC at Pereyaslavka Rayon Hospital and Polyclinic in Russia has been providing her colleagues with recommendations and guidelines on the use of central venous catheters as well as with access to databases on neurological diseases and medicines. She has also introduced an interactive software program to provide training on diabetes. Using CD-ROMs from the LRC as well as the results of a Medline search, physicians at Lviv Polyclinic No. 5 were able to correctly identify the proper treatment for a 9 year old girl who was experiencing a severe allergic reaction. LRC Outreach Into the Community
The Tbilisi EMS Training Center is working to establish two satellite training centers in Georgia (in Kutaisi and Batumi). As part of the new training centers, they are planning to establish LRCs with newly trained information coordinators at each of the satellite sites. The EMS Center has also received a new computer workstation through a PIMS project, which aims to support the development of a Center for Disaster and Emergency Medicine (CDEM) with satellite centers throughout Georgia. They are planning to establish an info coordinator position at each of the main medical institutions participating in this network. Training in basic computer skills was conducted in February for all new employees of the CDEM. After relying on the LRC at the City Health Department to access information for the past several years, the Central City Hospital in Dubna, Russia, decided to establish its own Internet connection in March. This has made information much more accessible to hospital staff. Subsequently, a physician from the hospital was confronted with a case of a pregnant woman with a medical condition in which 78% of cases end in death. However, with the help of the information obtained from the Internet, the doctor was able to save both the patient and the child. In March, staff at Schuche Rayon Central Hospital in Russia used information from the Internet-including on-line obstetrics and gynecology journals-to prepare presentations on family planning, menopause, and pregnancy. These presentations were used in lectures that were given to teenagers, parents and medical staff in the region. In February, the Donetsk Trauma Hospital Web site ( received an award from
the HealthAtoZ Web site ( for having met or exceeded rigorous standards for
inclusion in its search engine. The Donetsk Trauma Hospital Web site, a clearinghouse for Russian-
language and local medical resources, is listed in many medical search engines and last year signed the
HONCode, a code of conduct for the provision of authoritative and reliable medical information on the
Internet. Due to the high visibility of the Donetsk Web site on the Internet, the hospital physicians will
collaborate with colleagues in Germany to set up teleconsultations for patients with severe trauma and
unclear diagnoses. This project will be implemented in conjunction with Donetsk Medical University.
Staff at the Dubna City Health Department are using information from the Internet to prepare a chemical dependency prevention program for schoolchildren and a training course for teachers, both of which are being organized by the "Renaissance Center" in Dubna. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) The Web site for the Jessenius Faculty of Medicine, Comenius University in Martin, Slovakia now
features "A Handbook of Ovoscopic Diagnosis of Intestinal Helminths," an English-language publication
produced by the Institute of Epidemiology of the Comenius University. Tibor Baska, an information
coordinator and co-author of the handbook, has used the Internet and other communication resources to
promote this institutional publication. After posting an abstract and graphical images on the Faculty of
Medicine Web site, Tibor had contacted Webmasters of relevant sites and posted messages about the
handbook through various discussion groups. (
In March, Ilia Razmadze of the Tbilisi State Medical University completed work on the creation of a scientific journal for the university. The "Annals of Scientific Research" will publish scientific and review articles written by staff at the University. Articles will be reviewed and approved by members of the scientific department. The University is also planning to post a version of the journal on its Web site. The Web site for the University Hospital of Infectious Diseases ( in Zagreb, Croatia has
recently been expanded to include a new section on congresses, symposia and meetings that the hospital
is organizing this year. The current announcements include the 2nd Symposium on Sexually Transmitted
Diseases, to be held on May 16-18, 2000, and the 2nd Croatian Congress on Infectious Diseases, planned
for September 24-27, 2000. Both events are open to international participation.
In January, Kaliya Toguzbaeva of the Institute of Obstetrics and Pediatrics in Bishkek gave a presentation about the dangers of drug use, alcoholism and tobacco to 10th grade students from the Turkish-Kyrgyz high school. She used information materials from the Internet to prepare the presentation and invited the students to visit the LRC to receive additional information. Promoting LRC / Partner Sustainability
Erebuni Medical Center in Yerevan, Armenia, recently changed its charter in order to allow it to offer paid computing services through the LRC. The information coordinator, Armen Parsadanian, has been working to register with the tax authorities, and is planning to introduce a new system of operations for the LRC whereby each department of the Medical Center will provide funds from their budgets to cover part of the LRC's costs. In addition, individual physicians and staff will be able to pay for personal information requests at the LRC. Health professionals from other health institutions in the city can also pay to use the LRC. To support the future sustainability of the LRC, many partners have begun charging small fees for computer and Internet services. In this quarter, the Semipalatinsk State Academy Clinical Training Center - East Kazakhstan Oblast Rehabilitation Center has begun charging fees to non-medical staff who want to use the LRC for copying, Internet searching, printing and scanning services. Also, the Maternal and Child Health Center in Mtskheta-Mtianeti, Georgia, is planning to establish small user fees for people wishing to use the LRC's computer services. They plan to use the money generated from these fees to buy paper, diskettes, and fuel for the center's generator. Alexander Meshkov, the information coordinator at Stavropol City Hospital No. 2, asks health professionals from other institutions in Stavropol to provide basic supplies, such as paper and diskettes in exchange for the information searches that he is conducting for them. Jarmila Potomkova of Palacky University in Olomouc, Czech Republic, was successful in two grant proposals which she submitted last year. The first grant -- for $28,000 -- will establish an Ultra*Net CD-ROM server with a Web-based interface, which will allow the University library to provide remote access to multimedia files archived on CD-ROM. The second proposal -- for $30,000 -- will provide the library with a digital copier/printer as well as a special collection of 12 pharmacological journals. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) Eva Lesenkova from the Postgraduate Medical School in Prague successfully applied for a four-year grant
from the Grant Agency of the Czech Ministry of Education. The grant proposal, entitled "The Medical
Virtual Library (MEDVIK) - Network of Information Resources for Science and Research" is focused on
developing MEDVIK as a tool for sharing unique periodical titles, which the School's medical library
possesses, for the benefit of medical science. Eva is planning to place guidelines for (a) the presentation
of experimental protocols and reports, (b) data documentation and data storage in basic health research
and (c) guidelines concerning authorship on the Medical School's Web site (
Zhyldyz Ismailova, information coordinator at the Kyrgyz State Medical Academy in Bishkek recently won third prize in a Soros competition for designing the best Web site for an educational institution. Third prize was a new computer, which the Academy is planning to use as a server for developing a local area network to connect the LRC, library and computer center. Zhyldyz has also applied for World Bank funding to help install a dedicated connection for the Academy's network. The Bishkek Institute of Oncology and Radiology has been reaping a variety of benefits from its active e-mail correspondence over the past quarter. In March, the Institute joined an EU-sponsored "New Technology Cervical Cancer Partnership," thanks in part to the e-mail based collaboration between the Institute and colleagues in Greece. Through the project, the Institute will work with the Greek organization, "Our Lady," to evaluate the new PAPNET technology, which is used for cytology diagnostics of early cervical cancer. Similarly, thanks to the e-mail correspondence with the Russian Institute of Pediatric Hematology, the Institute has been included in a multicenter research study on childhood leukemia and will be receiving chemotherapy drugs from Germany and Russia for clinical trials and research. Finally, the Institute's Pediatric Oncology Department has recently received a donation of chemotherapy drugs, antibiotics, and other medicines from German colleagues. The head of the department is hoping to use the drugs to treat children with leukemia. Physicians at the Hospital of Occupational Medicine in Cluj-Napoca, Romania have developed a manual on occupational medicine, which they are planning to post on their Web site ( The Hospital also plans to sell copies of the Romanian-language manual in hard copy or on CD-ROM. Funds earned through sales of the manual will go to support the continued operations of the LRC. The University Hospital Center "Mother Teresa" in Tirana, Albania recently won a grant from the Soros Foundation to install a local area network at the hospital and to provide an Internet connection through the network. The LRC, which now includes four networked computers, moved to its new office in March. The LRC at the School of Health Administration of the National Institute of Health in Yerevan, Armenia has received over 200 books from its US partners--the University of Alabama at Birmingham and Creighton University. Internet Consultations
Dr. Peter Krcho, a neonatologist from Faculty Hospital in Kosice, Slovakia, has been actively using the LRC's digital camera to conduct teleconsultations with specialists from around the world. Dr. Krcho is regularly sending photographs and X-rays to partners in Providence as well as to other neonatologists he has met through the Internet. He has consulted on over a dozen complicated cases, with diagnoses ranging from femoral facial syndrome to nemaline rod myopathy. Dr. Krcho credits the consultations with saving several neonates at the NICU. At the NICU, physicians have also started using a laptop during rounds in order to consult with the Cochrane Database of Systematic Reviews during discussion of various cases. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) In January, information coordinators from two new partnership LRCs provided e-mail consultations for two sustainability partners. Anahit Mkhitaryan from the Sevan Polyclinic in Armenia responded to a request from Romania dealing with a case of sacrococcygeal teratoma. Anahit and her colleagues directed the Romanian physicians to two similar cases they found at the University of Iowa Virtual Hospital Web site. In another case, Anatoly Volkov from Central Medical Unit No. 15 in Snezhinsk, Russia responded to a consultation request from partners in Latvia who were treating a sick child. Anatoly coordinated with several specialists to provide their professional opinions by e-mail. In March, a pediatric ophthalmologist from the Institute of Oncology and Radiology in Bishkek requested an e-mail consultation for a patient with acute bilateral exophthalmus. The patient's case record was sent along with scanned CT images and a photo to the AIHA partnership mailing list. The physician received consultation support from the Institute's US partners at Kansas University Medical Center as well as from physicians in Prague, Bratislava, Moldova, and Romania. Most of the respondents agreed that the diagnosis was pseudotumor of the orbitor with acute idiopathic orbital myositis, which is a rare nosologic form of the disease with an obscure etiology. Physicians have not been able to pursue the recommended treatment (corticosteroid therapy), however, because they do not yet have the necessary drugs. In January, Julia Muravievskaya from the Health Department of the Dubna Mayor's Office, was asked to find urgently needed supplies for hemodialysis machines. Julia found a company on the Internet which produces the supplies, contacted them by e-mail, and was able to obtain the necessary supplies. Besik Lukhutashvili assisted his colleagues at the National Health Management Center in Tbilisi in sending an X-ray image by e-mail to colleagues in Germany to receive a consultation. The Georgian physicians received useful treatment advice as a result. Physicians at the Center have also used Internet to find other clinics that are providing reconstructive surgery. This was in response to a patient who was born without a left wrist. After finding a clinic in the UK, the parents of the child have contacted the British physicians to arrange for surgery. Raisa Cherkashina of the Korsakov Rayon Hospital and Polyclinic in Russia has recently begun helping her colleagues prepare teleconsultation requests. Using the LRC's scanner, Raisa is preparing photos, which she is sending out with the case histories by e-mail. Physicians at the hospital sent out two teleconsultation requests in January. One of these requests-for a patient with lymphangioma of the upper lip-received a response from physicians at the Institute of Oncology and Radiology in Bishkek, who advised the application of external radiotherapy. In February, the head of the Onco-Hematology Clinic of Pediatrics in Tirana, Albania, communicated by e-mail with a hospital in Pisa, Italy, to request assistance in dealing with cytostasis. The Italian hospital subsequently sent urgently needed medications to the clinic in Tirana. Physicians at the Maternal and Child Health Center in Mtskheta-Mtianeti, Georgia, regularly consult by e-mail with specialists in Tbilisi. For example, in February they had a case of a child who was born with a spinal hernia. After sending an e-mail to colleagues in Tbilisi, a specialist came to Mtskheta to help treat the patient. Communications And Information Exchange
Epidemiologists at the Inspectorate of Public Health in Cluj-Napoca, Romania, have been using e-mail to communicate with the Ministry of Health concerning the monitoring of viral hepatitis in children (0-4 years old) and also concerning viral respiratory infections. According to the information coordinator, Learning Resource Center (LRC) Project American International Health Alliance (AIHA) Doina Suciu, e-mail has become an important mode of communications with the Ministry of Health. This has been made possible by the World Bank, which has financed the setup of a LAN at the Inspectorate, which links them to the Ministry of Health using specialized phone lines. This network has one server and 6 computers with full Internet access. Through this project, the Ministry of Health is covering payments for Internet access. Since being connected to the Internet in January, health professionals at the Women's Wellness Center in Iasi, Romania have begun actively using the Internet. All staff at the Center have personal e-mail addresses which they are using to correspond with patients about health issues and problems. They also communicate with other colleagues about various cases and problems, and information from the Internet frequently helps them with decision-making. Staff are also finding information about family planning and are using the LRC scanner to develop patient materials for their pregnancy course (images for exercise, posture and comfort during pregnancy). Laura Coca, the information coordinator, is providing information support to her colleagues during weekly sessions where they discuss various cases and professional issues. Through a joint Japanese-Kazakh project, the Semipalatinsk State Academy Clinical Training Center - East Kazakhstan Oblast Rehabilitation Center has established a satellite link, which allows them to regularly exchange data from the Center's oncology database. The database includes ultrasound and microscope images along with diagnoses. The satellite link is also being used to conduct videoconferences in support of the project. The University Hospital Center "Mother Theresa" in Tirana, Albania, is currently involved in a partnership with the Nursing School of Switzerland. Nurses at the hospital have been exchanging opinions via e-mail on how to improve the teaching program of their next nurse training course. When the Swiss partners visited Tirana to deliver the course, they found that our nursing staff was well-prepared for the program for this year, and they hope to continue this e-mail-based correspondence in preparation for future courses. Dr. Peter Krcho of Faculty Hospital in Kosice, Slovakia, has spearheaded the development of an "Open Medical Club" that discusses various clinical topics through the Internet (chat and e-mail). In March, the Club, which includes physicians from a broad range of clinical specialties, discussed a lecture on the role of handwashing in preventing nosocomial infections. The Club has also held chat sessions to discuss topics such as the antibiotic protocols used by different medical departments at various Slovak health care institutions. The Nursing Resource Center at the Kyrgyz Medical Academy in Bishkek recently utilized the KyrgyzMedUz network (an AIHA-sponsored network that has connected the oblast health departments in each of Kyrgyzstan's six oblasts to e-mail and the Internet) to conduct an on-line nursing conference. Thanks to the network, representatives from each Kyrgyz oblast were able to participate in discussions and presentations. In February, physicians in the pharmacology department at the Kyrgyz State Medical Academy communicated with representatives from WHO regarding their recommended program for teaching clinical pharmacology and pharmacotherapy. These physicians are members of the European Association for Clinical Pharmacology and Therapeutics and are currently working on developing a training program for students and postgraduate specialists. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) Adriana Galan of the University of Medicine and Pharmacy in Bucharest, Romania, recently provided copies of the EpiInfo software along with reference materials by e-mail to health professionals in Arad, Romania who were searching for it. Hematologists at Trans-Carpathian Oblast Hospital in Uzhgorod, Ukraine recently used e-mail to contact colleagues in Hungary to exchange opinions and experiences relating to the treatment of hematology patients. Physicians from the heart surgery department at the Semipalatinsk State Academy Clinical Training Center - East Kazakhstan Oblast Rehabilitation Center recently contacted the Syganov Institute in Almaty for advice on conducting pediatric heart surgery. The physicians also contacted a pharmaceutical company in St. Petersburg to obtain medications necessary for the operations. Residents from the Hospital of Occupational Medicine in Cluj-Napoca, Romania are regularly using Ovid to find interesting full-text medical journal articles. Each day, one resident is responsible for giving a presentation to all medical staff in the hospital about an interesting article that he or she has found. In March, physicians at Kharkiv Oblast Student Polyclinic obtained information on the treatment of adenomyosis from the Web site (, which was used for a conference on women's health. The Web site features medical journals, including the Formula of Women's Health, where physicians found relevant information. Health Policy Change and Medical Curriculum Reform
Using e-mail, a group of chemists from the Inspectorate of Public Health in Cluj-Napoca, Romania contacted their counterparts from RELAD, an organization in Bucharest that deals with laboratory accreditation. Through this communication, they arranged for RELAD to organize a training course in Cluj dealing with accreditation topics. The Inspectorate invited representatives from other laboratories in Cluj to attend the course as well. In February, Olga Asatiany and her colleagues at the EMS Training Center in Tbilisi, Georgia, have used information from the Internet and CD-ROM databases to compose an English-language first aid course as well as evidence-based practice guidelines on emergency medicine. In preparing to establish a new specialized department dealing with occupational medicine for factories,
the Hospital of Occupational Medicine in Cluj-Napoca, Romania has been obtaining international
regulations and standards from the Web sites of the Internatonal Labor Organization ( and
World Health Organization (
Application of Information Technology, Telemedicine, and Database Information Systems
With the support of a software specialist, Laura Coca and her colleagues at the Iasi, Romania Women's Wellness Center have developed a program to help conduct surveys of the patients treated at the center. This program was demonstrated at a medical information management workshop in Romania, and it is now planned that the software will be provided to all family planning centers in the country. The Center Web page will soon feature a form that patients can use to ask about health problems by e-mail. Andrey Bordashov of Medical-sanitary Unit No. 50 in Sarov, Russia has begun work on developing a patient record database for his institution. The database will establish a unique identifier (similar to a U.S. Learning Resource Center (LRC) Project American International Health Alliance (AIHA) Social Security Number) for each patient, which can be used to document a person's complete medical record and history. The database will also be used to develop city-wide statistics and reports, detailing such information as the amount of drugs used. It is hoped that the database may become a standard for use throughout all medical institutions in the city. Larisa Shevtsova of Murmansk City Ambulance Hospital has developed a database application for use by the hospital's histology department. She is also working to connect the department to the hospital network so that information from the database can be distributed more widely and quickly throughout the hospital. Mersed Ahmetbegovic, information coordinator from the University Clinical Center in Tuzla, Bosnia, has developed a database application for the cardiovascular clinic, and is working on a similar database for another clinic. Mersed hopes to develop a larger database that can be used throughout the Center through a LAN, which they are planning to install. The University of Medicine and Pharmacy in Bucharest, Romania, has developed a reproductive health database in collaboration with the Centers for Disease Control and Prevention (CDC) in the U.S. Through this project, the CDC will provide training on SAS (statistics software) and database analysis for staff at the University, including the information coordinator. Useful Resources and Tips for Info Coordinators Nino Berdzuli and her colleagues at the Women's
Wellness Center in Kutaisi, Georgia, have recently started taking free English-language lessons using e-
mail and Internet chat. The lesssons are available through the Web at
Galina Sergeeva recommends the following useful Web sites: * In addition to using Ovid, info coordinators can access free Medline databases through Internet Grateful
Med ( and PubMed (
* An interesting book "The Whole Brain Atlas" can be found at The Virtual Doctor
(, which includes Russian and English versions.
* There is a useful catalog of Russian-language medical mailing lists dealing with oncology at
* Another very useful site for medical oncologists is at This site includes "Dose Calculation" software that
helps you to calculate a dose of chemotherapy using different protocols for different cancers (for adults).
A medical oncologist puts in data on weight, height and other parameters, selects a disease, a
chemotherapy (there are lists of types of cancer and antitumor drugs in the software), and the dose is
calculated automatically. The physicians at the Institute of Oncology and Radiology in Bishkek find this
software very helpful in selecting a method of therapy.
* Radiotherapy doctors downloaded helpful information on combined modality therapy of non-small-cell
lung cancer as the most difficult for therapy type of cancer ("Materials of 3rd annual Russian oncology
conference" at
Ion Chernokan, a physician at the Chisinau Emergency Hospital in Moldova has recently discovered the
Web site for the Medical Algorithms Project (, which contains over 1600 algorithms for
Learning Resource Center (LRC) Project American International Health Alliance (AIHA) a wide range of medical disciplines. The site is designed primarily for scientific researchers, but is also useful for practicing physicians and medical students. Andrey Bordashov from Medical-sanitary Unit No. 50 in Sarov, Russia has found a mailing list and Web
site dealing with the application of telemedicine in Russia. The Web site ( is organized
by the Center for Telemedicine at Archangelsk Oblast Clinical Hospital. Using both the Web site and
mailing list, Andrey has found useful information and resources related to the clinical and economic
aspects of using telemedicine technologies.
Staff at the Second Tashkent State Medical Institute in Uzbekistan are frequently using the
( Web site to find information on drugs, pharmaceutical companies, medical publishers,
on-line medical journals, and more.
Learning Resource Center (LRC) Project American International Health Alliance (AIHA)


Evolutionary Ecology Research , 2002, 4 : 1017–1032 Generations of the polyphenic butterfly Araschnia levana differ in body design 1Department of Zoology, School of Biological Sciences, University of Southern Bohemia and 2Institute of Entomology, Czech Academy of Sciences, Branisˇovská 31, CZ-370 05 Cˇeské Budeˇjovice, Czech Republic ABSTRACT The European Map Butterfly

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