Virtual reality exercise to help COVID patients with refractory breathlessness

Background: Immersive virtual reality (iVR)-based digital therapeutics (DTx) are gaining clinical attention in the field of pain management. Based on known analogy between chronic pain and dyspnea, we investigated the effects of visual respiratory feedback in iVR, on refractory breathlessness in patients recovering from severe COVID-19 pneumonia. Methods: We performed a controlled, randomized, single-blind, cross-over clinical study to evaluate an iVR-based intervention to alleviate refractory breathlessness in patients recovering from COVID-19 pneumonia. The single-site study was conducted at the university hospital of Geneva, Switzerland. Patients reported refractory breathlessness (≥5 on a 10-point dyspnea scale) and had a MoCA score of ≥24. Cross-over groups were randomly assigned, concealed from the referring clinician. Participants received synchronous (intervention) or asynchronous (control) feedback of their breathing, embodied via a gender-matched avatar in iVR. Prior to the first exposure and following both experimental conditions, patients completed questionnaires. Breathing patterns were captured continuously. The COVVR clinical study is registered with ClinicalTrials.gov (NCT04844567) and is now closed. Findings: Study enrollment was open between November 2020 and April 2021. A total of 26 patients (27% women; age: mean=57, SD±12) were enrolled; 14 patients were randomly assigned to the ″synchronous/asynchronous″ sequence, 12 to the ″asynchronous/synchronous″ sequence. Data was available for all except two (7.7%) of 26 patients. The mean rating of breathing comfort was 0.1 at baseline, 0.8±1.8 for asynchronous, and 1.3±1.4 synchronous feedback (estimated difference of 0.5 (95%CI 0.05 to 1.04; p<0.05) between iVR conditions). Of all patients, 91.2% were satisfied with the intervention (1.8±1.6, t=5.201, p<0.0001, 95%CI 1.173 to inf) and 66.7% perceived it as beneficial for their breathing (0.7±1.9, t=1.806, p<0.05, 95%CI 0.036 to inf). No adverse events were reported. Interpretation: Based on these findings, we propose that our iVR-based DTx is a feasible and safe neuro-rehabilitation tool that improves breathing comfort in patients recovering from severe COVID-19 infection. More research is needed to generalize this tool in other groups of patients suffering from refractory breathlessness.

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A CLINICAL STUDY OF SCREENING AND GRADING OF RETINOPATHY OF PREMATURITY IN THE UNIVERSITY HOSPITAL OF SOUTH INDIA

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/448 ◽

2018 ◽

Vol 5 (29) ◽

pp. 2165-2168

Author(s):

Sharubanaa Arun

Keyword(s):

Clinical Study ◽

Retinopathy Of Prematurity ◽

South India ◽

University Hospital ◽

The University

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Virtual Reality for Supporting Surgical Planning

Handbook of Research on Developments in E-Health and Telemedicine ◽

10.4018/978-1-61520-670-4.ch029 ◽

2010 ◽

pp. 614-635

Author(s):

Sandra Leal ◽

Cristina Suarez ◽

J. M. Framinan ◽

Carlos Luis Parra ◽

Tomás Gómez

Keyword(s):

Virtual Reality ◽

Surgical Procedures ◽

Predictive Models ◽

Surgical Planning ◽

Personal Characteristics ◽

Manual Dexterity ◽

University Hospital ◽

Complex Scenario ◽

Visualization Techniques ◽

The University

Nowadays many surgical procedures are still carried out based on the skills and manual dexterity of each surgeon. The complexity and variability of the operations (very dependent on anatomical and functional personal characteristics), the difficulty of sharing and transferring the acquired knowledge, and the problems for surgeons to train in a realistic context make up a very complex scenario. In this sense, Virtual Reality (VR) provide supporting for surgical training and planning. VR permits modeling, simulation and visualization techniques using 3-D, anatomical predictive models, which are based on realistic models of tissues and organs. The usage of these technologies as a support for surgical planning results in a reduction of the uncertainty in the surgical process, a decrease in the risks for the patients, as well as an improvement of the results. This chapter presents a case of study of a Virtual Reality tool for supporting surgical planning, called VirSSPA, that has been already successfully applied in the University Hospital “Virgen del Rocio” (Seville-Spain).

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Epidemiological and Clinical Study of Cardiac Diseases in the Pediatric Department of the University Hospital Gabriel Touré (UH GT), Bamako (Mali)

World Journal of Cardiovascular Diseases ◽

10.4236/wjcd.2018.87032 ◽

2018 ◽

Vol 08 (07) ◽

pp. 328-336

Author(s):

Maiga Belco ◽

Bâ Hamidou Oumar ◽

Sacko Karamoko ◽

Dembélé Adama ◽

Sanogo Nouhoum ◽

...

Keyword(s):

Clinical Study ◽

University Hospital ◽

Cardiac Diseases ◽

Pediatric Department ◽

The University

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P105 Ambulatory study center at the University of Basel Children’s Hospital (UKBB)

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-esdppp.143 ◽

2019 ◽

Vol 104 (6) ◽

pp. e61.2-e62

Author(s):

C Werner ◽

R Santoro ◽

J Bielicki

Keyword(s):

Clinical Study ◽

Clinical Research ◽

Clinical Studies ◽

Quality Management System ◽

Full Range ◽

The United States ◽

University Hospital ◽

Specialized Team ◽

The University ◽

Study Center

BackgroundMany drugs authorized in Europe and the United States are inadequately studied in children. SwissPedNet Funding has boosted the development of specialized and professional pediatric centers for clinical studies in Switzerland tasked with executing compliant, reliable and family-centered clinical research. The University of Basel Children`s Hospital (UKBB) is one of the pediatric clinical study centers.MethodsThe Department for Clinical Research in Basel consists of the study center for adults at University Hospital Basel (USB) and the Ambulatory Study Center (ASZ) focusing on pediatric studies at the UKBB. The latter was established in 2015, and consists of a specialized team, including a medical director, medical coordinator, medical specialists in pediatrics as well as a team of study nurses.The ASZ supports and promotes clinical studies with and for infants and children for external and internal sponsors in various therapeutic areas such as oncology, cardiology, pneumology, nephrology, neuropediatrics, orthopaedics and infectious diseases. The full range of activities for executing the approved clinical study protocol can be offered, including planning, implementation, budgeting, coordinating, monitoring and archiving as well as collaboration with all required hospital departments.ResultsUp to now, the ASZ has enrolled around 600 children in clinical trials, with 6 studies completed and 12 studies ongoing. A comprehensive Quality Management system was established and SOPs were jointly created with the adult study center. A digital clinical study request form is available for sponsors via the website.ConclusionWe see an increased demand for pediatric clinical studies across all age ranges and therapeutic areas. We envision a center of excellence with a pool of fully trained study nurses to accommodate and centrally organize all pediatric studies in the UKBB. Parent engagement and patient inclusion is one critical step to further improving healthcare for pediatric patients through highest quality clinical research.Disclosure(s)Nothing to disclose

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Abstract #216: Knowledge About Inpatient Diabetes Management: Impact of an Educational Intervention in Nurses at the University Hospital of Puerto Rico

Endocrine Practice ◽

10.1016/s1530-891x(20)42522-4 ◽

2015 ◽

Vol 21 ◽

pp. 30-31

Author(s):

Anette Garces-Dominguez ◽

Loida Gonzalez-Rodriguez ◽

Monica Vega ◽

Myriam Allende-Vigo

Keyword(s):

Puerto Rico ◽

Educational Intervention ◽

Diabetes Management ◽

University Hospital ◽

Inpatient Diabetes ◽

Inpatient Diabetes Management ◽

The University

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Symptomatic vascular complications after vascular closure device use following diagnostic and interventional catheterisation

VASA ◽

10.1024/0301-1526.33.2.78 ◽

2004 ◽

Vol 33 (2) ◽

pp. 78-81 ◽

Cited By ~ 21

Author(s):

Thalhammer ◽

Aschwanden ◽

Jeanneret ◽

Labs ◽

Jäger

Keyword(s):

Current Literature ◽

Vascular Complications ◽

University Hospital ◽

Closure Device ◽

Ultrasound Guided ◽

Vascular Closure Device ◽

Device Use ◽

Arterial Stenoses ◽

The University ◽

Stenotic Lesions

Background: Haemostatic puncture closure devices for rapid and effective hemostasis after arterial catheterisation are a comfortable alternative to manual compression. Implanting a collagen plug against the vessel wall may become responsible for other kind of vascular injuries i.e. thrombotic or stenotic lesions and peripheral embolisation. The aim of this paper is to report our clinically relevant vascular complications after Angio-Seal® and to discuss the results in the light of the current literature. Patients and methods: We report the symptomatic vascular complications in 17 of 7376 patients undergoing diagnostic or therapeutic catheterisation between May 2000 and March 2003 at the University Hospital Basel. Results: Most patients presented with ischaemic symptoms, arterial stenoses or occlusions and thrombotic lesions (n = 14), whereas pseudoaneurysms were extremely rare (n = 3). Most patients with ischaemic lesions underwent vascular surgery and all patients with a pseudoaneurysm were successfully treated by ultrasound-guided compression. Conclusions: Severe vascular complications after Angio-Seal® are rare, consistent with the current literature. There may be a shift from pseudoaneurysms to ischaemic lesions.

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User Evaluation of an Integrated Medical Workstation for Clinical Data Analysis

Methods of Information in Medicine ◽

10.1055/s-0038-1634954 ◽

1993 ◽

Vol 32 (05) ◽

pp. 365-372 ◽

Cited By ~ 2

Author(s):

T. Timmeis ◽

J. H. van Bemmel ◽

E. M. van Mulligen

Keyword(s):

Data Analysis ◽

Clinical Research ◽

Clinical Data ◽

University Hospital ◽

User Evaluation ◽

Scientific Staff ◽

Medical Institutions ◽

Clinical Data Analysis ◽

Research Problems ◽

The University

AbstractResults are presented of the user evaluation of an integrated medical workstation for support of clinical research. Twenty-seven users were recruited from medical and scientific staff of the University Hospital Dijkzigt, the Faculty of Medicine of the Erasmus University Rotterdam, and from other Dutch medical institutions; and all were given a written, self-contained tutorial. Subsequently, an experiment was done in which six clinical data analysis problems had to be solved and an evaluation form was filled out. The aim of this user evaluation was to obtain insight in the benefits of integration for support of clinical data analysis for clinicians and biomedical researchers. The problems were divided into two sets, with gradually more complex problems. In the first set users were guided in a stepwise fashion to solve the problems. In the second set each stepwise problem had an open counterpart. During the evaluation, the workstation continuously recorded the user’s actions. From these results significant differences became apparent between clinicians and non-clinicians for the correctness (means 54% and 81%, respectively, p = 0.04), completeness (means 64% and 88%, respectively, p = 0.01), and number of problems solved (means 67% and 90%, respectively, p = 0.02). These differences were absent for the stepwise problems. Physicians tend to skip more problems than biomedical researchers. No statistically significant differences were found between users with and without clinical data analysis experience, for correctness (means 74% and 72%, respectively, p = 0.95), and completeness (means 82% and 79%, respectively, p = 0.40). It appeared that various clinical research problems can be solved easily with support of the workstation; the results of this experiment can be used as guidance for the development of the successor of this prototype workstation and serve as a reference for the assessment of next versions.

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Sharing of Worldwide Spread Knowledge Using Hypermedia Facilities & Fast Communication Protocols (Mosaic and World Wide Web): The Example of ExPASy

Methods of Information in Medicine ◽

10.1055/s-0038-1634588 ◽

1995 ◽

Vol 34 (01/02) ◽

pp. 75-78 ◽

Cited By ~ 5

Author(s):

R. D. Appel ◽

O. Golaz ◽

Ch. Pasquali ◽

J.-C. Sanchez ◽

A. Bairoch ◽

...

Keyword(s):

World Wide Web ◽

World Wide ◽

Relevant Literature ◽

Communication Protocols ◽

Laboratory Data ◽

Central Element ◽

University Hospital ◽

New Information ◽

The University ◽

Link Information

Abstract:The sharing of knowledge worldwide using hypermedia facilities and fast communication protocols (i.e., Mosaic and World Wide Web) provides a growth capacity with tremendous versatility and efficacy. The example of ExPASy, a molecular biology server developed at the University Hospital of Geneva, is striking. ExPASy provides hypermedia facilities to browse through several up-to-date biological and medical databases around the world and to link information from protein maps to genome information and diseases. Its extensive access is open through World Wide Web. Its concept could be extended to patient data including texts, laboratory data, relevant literature findings, sounds, images and movies. A new hypermedia culture is spreading very rapidly where the international fast transmission of documents is the central element. It is part of the emerging new “information society”.

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