scholarly journals Telemonitoring with Electronic Devices in Patients with a Single Ventricle Anatomy

2021 ◽  
Vol 69 (S 03) ◽  
pp. e53-e60
Author(s):  
Peter A. Zartner ◽  
Nathalie Mini ◽  
Diana Momcilovic ◽  
Martin B. Schneider ◽  
Sven Dittrich
Keyword(s):  
Standard Deviation ◽  
Clinical Relevance ◽  
Single Ventricle ◽  
Electronic Device ◽  
Home Monitoring ◽  
Difficult Patient ◽  
Intracardiac Electrogram ◽  
Number Of Patients ◽  
Exit Block ◽  
Cortisone Therapy

Abstract Background A growing number of patients with a single ventricle anatomy, who had a Fontan palliation as a child, are now reaching adulthood. Many need an epimyocardial pacemaker system with an optional telemonitoring (TM) unit, which evaluates the collected data and sends it via Internet to the patient's physician. There are no data on the reliability and clinical relevance of these systems in this patient group. Methods We analyzed data in 48 consecutive patients (mean age 18 years, standard deviation 9 years) with a Fontan or Fontan-like palliation who received a cardiac implantable electronic device with a TM unit from Biotronik (Home Monitoring) or Medtronic (CareLink) between 2005 and 2020 with regard to the reliability and clinical relevance of the downloaded data. Results The observation period was from 4 months to 14 years (mean 7 years, standard deviation 3.9 years). A total of 2.9 event messages (EMs)/patient/month and 1.3 intracardiac electrogram recordings/patient/month were received. Two patients died during follow-up. The combination of regularly arriving statistical data and 313 clinically relevant EMs led to the modification of antiarrhythmic or diuretic medication, hospitalization with cardioversion or ablation, and cortisone therapy to avoid exit block in 21 (44%) patients. Conclusion TM is an instrument to receive functional and physiologic parameters of our Fontan patients. It provides the ability to respond early for signs of system failure, or arrhythmia, even if the patient is not experiencing any problems. It is a useful tool to manage this difficult patient population without frequent hospital visits.

Developing a sense of self-reliance: caregivers of infants with single-ventricle heart disease during the interstage period

2021 ◽  
pp. 1-7
Author(s):  
Flerida Imperial-Perez ◽  
MarySue V. Heilemann ◽  
Lynn V. Doering ◽  
Jo-Ann Eastwood ◽  
Nancy A. Pike
Keyword(s):  
Heart Disease ◽  
Grounded Theory ◽  
Single Ventricle ◽  
Sense Of Self ◽  
Home Monitoring ◽  
Palliative Surgery ◽  
Constructivist Grounded Theory ◽  
Self Confidence ◽  
Self Reliance ◽  
Second Surgery

Abstract Background: Caring for infants after the first-stage palliative surgery for single-ventricle heart disease bring challenges beyond the usual parenting responsibilities. Current studies fail to capture the nuances of caregivers’ experiences during the most critical “interstage” period between the first and second surgery. Objectives: To explore the perceptions of caregivers about their experiences while transitioning to caregiver roles, including the successes and challenges associated with caregiving during the interstage period. Methods: Constructivist Grounded Theory methodology guided the collection and analysis of data from in person or telephonic interviews with caregivers after their infants underwent the first-stage palliative surgery for single-ventricle heart disease, and were sent to home for 2–4 months before returning for their second surgery. Symbolic interactionism informed data analyses and interpretation. Results: Our sample included 14 parents, who were interviewed 1–2 times between November, 2019 and July, 2020. Most patients were mothers (71%), Latinx (64%), with household incomes <$30K (42%). Data analysis led to the development of a Grounded Theory called Developing a Sense of Self-Reliance with three categories: (1) Owning caregiving responsibilities despite grave fears, (2) Figuring out how “to make it work” in the interstage period, and (3) Gaining a sense of self-reliance. Conclusions: Parents transitioned to caregiver roles by developing a sense of self-reliance and, in the process, gained self-confidence and decision-making skills. Our study responded to the key research priority from the AHA Scientific Statement to address the knowledge gap in home monitoring for interstage infants through qualitative research design.

How to decrease the rejection rates: reasons of sample rejection and solutions

2018 ◽  
Vol 43 (1) ◽  
pp. 98-100
Author(s):  
Saadet Celik ◽  
Tuncay Seyrekel ◽  
Medeni Arpa
Keyword(s):  
Information System ◽  
Patient Safety ◽  
Standard Deviation ◽  
Staff Training ◽  
Training Group ◽  
Laboratory Information System ◽  
Important Place ◽  
Number Of Patients ◽  
Rejection Rates

AbstractObjective:Sample rejection is an important step in the laboratory related with the patient safety. Periodical analysis of rejected samples is necessary to define the causes of rejection and follow-up the requirements for staff training. In this study, we aimed to put forth the efficiency of trainings by analyzing the amount of rejected samples in Yozgat State Hospital.Materials and methods:Taken from laboratory information system (LIS), rejected sample statistics related to 8 month-data before training was compared with 8-month data after training between 07.2015 and 10.2016 are examined. These datas were compared in itself and to each other. All statistical analyses were performed using the SPSS (V15).Results:Before training, the average number of patients for the analysis included months was 34,733 [standard deviation (SD)±4031], the number of rejected samples was 397.7 (SD±85.3) and the average rejection percentage was 1.13 (min-max: 1–1.29). The average number of patients for the after training months was 39,426 (SD±4779), the number of rejected samples was 343.2 (SD±57.7) and the average rejection percentage was 0.87 (min-max: 0.62–0.98), Rejected sample rates were significantly lower interms of statistics in the after-training group (p=0.0001).Conclusion:Staff training takes a very important place preventing these mistakes. As it can be seen in our study, training helps decreasing rejection rates. It is suggested to schedule more trainings in order to decrease the rates to lower degrees.

scholarly journals Covidom, a Telesurveillance Solution for Home Monitoring Patients With COVID-19 (Preprint)

2020 ◽  
Author(s):  
Youri Yordanov ◽  
Agnes Dechartres ◽  
Xavier Lescure ◽  
Caroline Apra ◽  
Pascaline Villie ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Web Application ◽  
Large Scale ◽  
Home Monitoring ◽  
Control Center ◽  
Regional Control ◽  
Global Pandemic ◽  
Number Of Patients ◽  
Paris Area ◽  
Innovative Solution

UNSTRUCTURED In a matter of months, COVID-19 has escalated from a cluster of cases in Wuhan, China, to a global pandemic. As the number of patients with COVID-19 grew, solutions for the home monitoring of infected patients became critical. This viewpoint presents a telesurveillance solution—Covidom—deployed in the greater Paris area to monitor patients with COVID-19 in their homes. The system was rapidly developed and is being used on a large scale with more than 65,000 registered patients to date. The Covidom solution combines an easy-to-use and free web application for patients (through which patients fill out short questionnaires on their health status) with a regional control center that monitors and manages alerts (triggered by questionnaire responses) from patients whose health may be deteriorating. This innovative solution could alleviate the burden of health care professionals and systems while allowing for rapid response when patients trigger an alert.

scholarly journals The Application of Radiofrequency Waves in Supportive Treatment of Temporomandibular Disorders

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
M. Pihut ◽  
M. Górnicki ◽  
M. Orczykowska ◽  
E. Zarzecka ◽  
W. Ryniewicz ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Extreme Values ◽  
Treatment Algorithm ◽  
Masticatory Muscles ◽  
Temporomandibular Joint Disorders ◽  
Control Group ◽  
Clinical Parameters ◽  
Supportive Treatment ◽  
Number Of Patients ◽  
Axis I

In recent years, the number of patients applying for prosthetic treatment due to temporomandibular joint disorders (TMD) has been increasing. The main methods for treating disorders are the use of occlusal splints and physiotherapeutic rehabilitation as supportive treatment. Radio waves are electromagnetic waves with radiation frequency between 3 Hz and 3 THz, used for physiotherapeutic treatment of skeletal muscle relaxation in the range of 3 to 6 MHz. The rehabilitation effect of these waves is based on diathermy by means of high-voltage quick alternating current. Aim. The aim of the study was to evaluate the influence of radiofrequency waves on the pain of the masticatory muscles in the course of TMD and the usefulness of these procedures in the supporting treatment of these disorders. Materials and Methods. Patients aged 19 to 45 years, of both sexes, reported to the Consulting Room of TMD at the Institute of Dentistry in Krakow to undertake prosthetic treatment of TMD (I a—according to RDC/TMD). Study group (SG) consists of 20 patients who had 10 supportive treatments with radiofrequency currents. In the case of application of radiation to the muscle area, the energy was 20 J to the area of the masticatory muscles, the frequency was 3 MHz, bipolar technique, the duration of the procedure was 10 minutes, and the coupling substance was a gel for ultrasound examinations. The control group (CG) consisted of 20 patients who had 10 supportive treatments with sonophoresis procedures. For the area of masticatory muscles, 0.9 W/cm2 treatments were applied, the duty factor was 80%, the treatment time was 10 minutes, and the medical substance was 25% Voltaren gel. Results. Analysis of the results of the first clinical examinations (axis I) conducted in both groups shows a homogeneous clinical material and similar results. The second clinical examination revealed improved clinical parameters, but it showed a greater improvement in the SG. In the SG, the mean level of VAS was 6.25, and the extreme values were 5.9–0.14, the median was 2.15, and the standard deviation was 1.54. In the CG, the average value of VAS was 6.20 (peak of 5.2–0.7), the median was 2.4, and the standard deviation was 1.87. Summary. The search for new methods of supportive treatment of TMD is an important research direction due to the complex etiology of this disease and the lack of an explicit treatment algorithm. Conclusion. The results of our own research clearly indicate that the use of the radiofrequency waves brings pain relief and improvement of clinical parameters to a greater extent than in sonophoresis. It can be a very important new method in supportive treatment of TMD. Research needs to be continued.

Pulse oximetry home monitoring in infants with single-ventricle physiology and a surgical shunt as the only source of pulmonary blood flow

2012 ◽  
Vol 23 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Annika Öhman ◽  
Eva Strömvall-Larsson ◽  
Boris Nilsson ◽  
Mats Mellander
Keyword(s):  
Oxygen Saturation ◽  
Single Ventricle ◽  
Home Monitoring ◽  
Shunt Complication ◽  
Single Ventricle Physiology ◽  
Life Saving ◽  
Shunt Occlusion ◽  
Life Threatening ◽  
Shunt Dysfunction ◽  
At Home

AbstractBackgroundShunt occlusion is a major cause of death in children with single ventricle. We evaluated whether one daily measurement of oxygen saturation at home could detect life-threatening shunt dysfunction.MethodsA total of 28 infants were included. Parents were instructed to measure saturation once daily and if less than or equal to 70% repeat the measurement. Home monitoring was defined as positive when a patient was admitted to Queen Silvia Children's Hospital because of saturation less than or equal to 70% on repeated measurement at home. A shunt complication was defined as arterial desaturation and a narrowing of the shunt that resulted in an intervention to relieve the obstruction or in death. Parents’ attitude towards the method was investigated using a questionnaire.ResultsA shunt complication occurred out of hospital eight times in eight patients. Home monitoring was positive in five out of eight patients. In two patients, home monitoring was probably life saving; in one of them, the shunt was replaced the same day and the other had an emergency balloon dilatation of the shunt. In three out of eight patients, home monitoring was negative; one had an earlier stage II and survived, but two died suddenly at home from thrombotic shunt occlusion. On seven occasions in three patients home monitoring was positive but there was no shunt complication. The method was well accepted by the parents according to the results of the questionnaire.ConclusionHome monitoring of oxygen saturation has the potential to detect some of the life-threatening shunt obstructions between stages I and II in infants with single-ventricle physiology.

Flunarizine vs. Pizotifen in Migraine Prophylaxis: A Review of Comparative Studies

Cephalalgia ◽  
1988 ◽  
Vol 8 (8_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Egilius LH Spierings ◽  
Harley B Messinger
Keyword(s):  
Standard Deviation ◽  
Comparative Studies ◽  
Statistical Significance ◽  
Secondary Analysis ◽  
Migraine Prophylaxis ◽  
Attack Frequency ◽  
Double Blind ◽  
Number Of Patients

Six double-blind studies have been published in which the efficacy of flunarizine and pizotifen were compared. In none of the studies were differences of statistical significance revealed for attack frequency. Secondary analysis of the three studies in which the same protocol was employed, using parametric tests on transformed data gave similar results. Pooling of the data in an attempt to enhance the power by enlarging the number of patients, actually decreased the power due to an increase in standard deviation.

scholarly journals A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Syed M. Asim Hussain
Keyword(s):  
Cohort Study ◽  
Standard Deviation ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Healing Rate ◽  
Leg Ulcer ◽  
University Hospital ◽  
Venous Leg Ulcer ◽  
Number Of Patients ◽  
The Difference

Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers.Study Design. Retrospective cohort study.Location. The leg ulcer clinic at the University Hospital of South Manchester.Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost.Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient.Results. Simple nonadherent dressings had a mean healing rate of 0.353 cm2/week (standard deviation ± 0.319) compared with a mean of 0.415 cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailedpvalue of 0.251 and a two-tailedpvalue of 0.508. Multiple regression analysis gave a significanceFof 0.8134.Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection.

Interstage Home Monitoring After Newborn First-Stage Palliation for Hypoplastic Left Heart Syndrome: Family Education Strategies

2017 ◽  
Vol 37 (2) ◽  
pp. 72-88 ◽  
Author(s):  
Jo Ann Nieves ◽  
Karen Uzark ◽  
Nancy A. Rudd ◽  
Jennifer Strawn ◽  
Anne Schmelzer ◽  
...  
Keyword(s):  
Home Care ◽  
Hypoplastic Left Heart Syndrome ◽  
Single Ventricle ◽  
Early Recognition ◽  
Home Monitoring ◽  
Growth Failure ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Growth And Survival ◽  
Left Heart Syndrome

Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period. A crucial focus of care is the comprehensive family training in the use of home surveillance monitoring of oxygen saturation, enteral intake, weight, and the early recognition of “red flag” symptoms indicating potential cardiopulmonary or nutritional decompensation. Beginning with admission to the intensive care unit of the newborn with hypoplastic left heart syndrome, nurses provide critical care and education to prepare the family for interstage home care. This article presents detailed nursing guidelines for educating families on the home care of their medically fragile infant with single-ventricle circulation.

scholarly journals Covidom, a Telesurveillance Solution for Home Monitoring Patients With COVID-19

10.2196/20748 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e20748
Author(s):  
Youri Yordanov ◽  
Agnes Dechartres ◽  
Xavier Lescure ◽  
Caroline Apra ◽  
Pascaline Villie ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Web Application ◽  
Large Scale ◽  
Home Monitoring ◽  
Control Center ◽  
Regional Control ◽  
Global Pandemic ◽  
Number Of Patients ◽  
Paris Area ◽  
Innovative Solution

In a matter of months, COVID-19 has escalated from a cluster of cases in Wuhan, China, to a global pandemic. As the number of patients with COVID-19 grew, solutions for the home monitoring of infected patients became critical. This viewpoint presents a telesurveillance solution—Covidom—deployed in the greater Paris area to monitor patients with COVID-19 in their homes. The system was rapidly developed and is being used on a large scale with more than 65,000 registered patients to date. The Covidom solution combines an easy-to-use and free web application for patients (through which patients fill out short questionnaires on their health status) with a regional control center that monitors and manages alerts (triggered by questionnaire responses) from patients whose health may be deteriorating. This innovative solution could alleviate the burden of health care professionals and systems while allowing for rapid response when patients trigger an alert.

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