scholarly journals An online mobile/desktop application for supporting sustainable chronic disease self-management and lifestyle change

2020 ◽  
Vol 26 (4) ◽  
pp. 2860-2876
Author(s):  
Reza Aria ◽  
Norman Archer
Keyword(s):  
Arterial Disease ◽  
Healthcare Management ◽  
Cost Of Care ◽  
Self Management ◽  
Use Of Technology ◽  
Patient Health ◽  
Group A ◽  
Health Quality ◽  
Peripheral Arterial ◽  
The Cost

Health self-management has become a new trend in healthcare management due to its effectiveness in improving patient health, quality of life, and life satisfaction and simultaneously reducing the cost of care. To evaluate the potential of mobile health, we developed an online health self-management system for mobile or desktop environment to help patients self-manage their health in home settings. Certain elements (e.g. education, entertainment, and rewards) were built into the system to encourage patients to both adopt and continue using it. The system was shown to two groups of patients: an Internet-panel group of 198 patients with one or more serious chronic illnesses and 83 peripheral arterial disease patients in an in-person study group. A statistical model based on Unified Theory of Acceptance and use of Technology in a consumer context was used to analyze the results. The results from both groups confirmed that such systems, from the perspectives of patients (in a “pre-use” stage), are useful, beneficial, and rewarding to use.

scholarly journals Infusion of iloprost without a peristaltic pump: Safety and tolerability

2013 ◽  
pp. 179-184
Author(s):  
Paola Faggioli ◽  
Leopoldo Giani ◽  
Antonino Mazzone
Keyword(s):  
Peripheral Arterial Disease ◽  
Adverse Reactions ◽  
Systolic Pressure ◽  
Arterial Disease ◽  
Cost Of Care ◽  
Peristaltic Pump ◽  
Flow Regulator ◽  
Set Up ◽  
Peripheral Arterial ◽  
Iloprost Infusion

Introduction: Iloprost is a potent prostacyclin (PGI2) analogue that is effective in the treatment of peripheral arterial disease, vasculitis, pulmonary hypertension, and secondary Raynaud’s phenomenon. Intravenous infusions are generally administered with the aid of a peristaltic pump to reduce the risk of adverse reactions caused by unintentional increases in the infusion rate. This increases the cost of care in terms of equipment and personnel and may limit the use of this drug. Materials and methods: We retrospectively analyzed 18,432 iloprost infusions administered between 1999 and 2009 to 272 patients with systemic sclerosis (n = 253) and 19 with peripheral arterial disease (n = 19). All infusions were administered in the day hospital over 6 h with a normal IV set-up with a roller flow regulator. Flow rates were set to deliver iloprost at 1-2 ng/kg/min. Rates were verified by direct drop counts during the first 15-20 minutes of the infusion and at each subsequent check. Results: There were no adverse events that were fatal, life-threatening, or associated with prolongation of hospitalization and very few events requiring intensive care or continuous monitoring. The latter included 4 cases of tachycardia/arrhythmia (extrasystoles in most cases), 3 cases of hypotension (systolic pressure < 80 mmHg), and 2 cases of hypertension (BP > 170/100 mmHg). All other adverse reactions were mild, reversible, and similar to those seen with iloprost infusion with peristaltic pump. Only one patient had to be switched to another prostanoid (due to intolerance). Discussion: Iloprost infusion administered with a normal IV flow regulator appears to be as safe, well tolerated, and effective as traditional infusion with a peristaltic pump.

scholarly journals C-Reactive Protein Predicts Progression of Peripheral Arterial Disease in Patients with Type 2 Diabetes: A 5-Year Follow-Up Study

2014 ◽  
Vol 33 (4) ◽  
pp. 347-355
Author(s):  
Ljiljana Popović ◽  
Katarina Lalić ◽  
Olga Vasović ◽  
Danijela Drašković Radojković ◽  
Nataša Rajković ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Peripheral Arterial

Summary Background: Previous studies have indicated that high sensitivity C-reactive protein (hs-CRP) is a risk factor for the peripheral arterial disease (PAD) in diabetes. This study aimed to evaluate the possible predictive significance of hs-CRP for the development and progression of PAD in patients with type 2 diabetes (T2D). Methods: The study included 80 patients previously diagnosed with T2D, aged 45–70 years, divided into group A (T2D patients with PAD; n=38) and group B (T2D patients without PAD; n=42). After five years, all the patients were re-examined and divided into subgroups depending on de novo development of PAD or progression of previously diagnosed PAD. Ankle-Brachial Index (ABI) measurement was used for PAD diagnosis and hs-CRP was determined by nephelometry. Results: We found significantly higher hs-CRP levels in group A compared to group B, but only at baseline. Among the patients in group A, those with later progression of PAD (subgroup A1) had the highest levels of hs-CRP at baseline, although not significantly different from those in subgroup A2 (non-progressors). In contrast, hs-CRP level was significantly higher in subgroup B1 (progressors) in comparison to subgroup B2 (non-progressors) at both the first and second exam. Of all the investigated metabolic parameters, hs-CRP was the only independent predictor of PAD progression (OR=0.456, 95% CI=0.267–0.7815, p=0.004). The cut-off point for hs-CRP was 2.5 mg/L (specificity 75% and sensitivity 73.3%) with the relative risk for PAD of 2.93 (95% CI=1.351–6.3629). Conclusions: Our study implies that hs-CRP can be used as a reliable predictor for the progression of PAD in patients with T2D.

scholarly journals Quality of life as a predictor of postoperative outcome following revascularization of peripheral arterial disease

2017 ◽  
Vol 5 (1) ◽  
pp. 315
Author(s):  
Shantonu Kumar Ghosh ◽  
Alpana Majumder
Keyword(s):  
Quality Of Life ◽  
Peripheral Arterial Disease ◽  
Postoperative Outcome ◽  
Arterial Disease ◽  
Related Quality ◽  
Health Related ◽  
Group A ◽  
Group B ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is associated with a significant morbidity and mortality. In addition to physical factors, patient’s quality of life (QOL) i.e. individual’s physical health, psychological state, level of independence, social relationships, and their relationship to salient features of their environment also influence on post-operative outcome and there by long term survival after surgery. Health related quality of life (HRQOL) is the extent to which one’s usual or expected physical, emotional and social well-being are affected by a medical condition or its treatment. The purpose of this study was to compere the health-related quality of life before and after revascularization following PAD and to identify the relationship with post-operative outcome following revascularization.Methods: Cases were divided into two groups according to presence and absence of ulceration in foot. Those patients having claudication with ulceration were enrolled in group A and those having claudication without ulceration were enrolled in group B. Data were collected from both groups preoperatively and during follow up at 1 month and 3 months by interviewing the patient according to SF-36. Results: Two groups with preoperative poorer HRQOL (n=25) or optimum HRQOL (n=25) were compared. Postoperative outcome was found poor in Group A compered to Group B. In both groups, there was little improvement in quality of life after 1 month of surgery. In Group A QOL improved a little between 1 to 3 months postoperatively. But in Group B, there was significant improvement of postoperative QOL between 1 and 3 months. Overall, Group A patients had preoperative symptoms more prominent and their postoperative outcome was also poor.Conclusions: Those patients who had preoperative optimum quality of life had better postoperative outcome. From this study it can be concluded that quality of life can be used as a predictor of postoperative outcome in peripheral arterial disease patients. 

scholarly journals Intercondylar Route of Prosthetic Infragenicular Femoropopliteal Bypass Has Better Primary, Assisted, and Secondary Patency but Not Limb Salvage Rate Compared to the Medial Route

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Tomas Grus ◽  
Lukas Lambert ◽  
Rohan Banerjee ◽  
Gabriela Grusova ◽  
Vilem Rohn ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Arterial Disease ◽  
Observation Time ◽  
Secondary Patency ◽  
Femoropopliteal Bypass ◽  
Limb Salvage Rate ◽  
Group A ◽  
Group B ◽  
Peripheral Arterial ◽  
Salvage Rate

Aim. To compare the differences between medial and intercondylar infragenicular femoropopliteal prosthetic bypasses in terms of their midterm patency and limb salvage rates.Methods. Ninety-three consecutive patients with peripheral arterial disease who underwent a simple distal femoropopliteal bypass using a reinforced polytetrafluorethylene graft were included in this retrospective study. The bypass was constructed in the intercondylar route in 52 of the patients (group A) and in 41 in the medial route (group B).Results. Median observation time of the patients was 12.7 (IQR 4.6–18.5) months. There were 22 and 24 interventional or surgical procedures (angioplasty, stenting, thrombolysis, thrombectomy, or correction of the anastomosis) performed to restore patency of the reconstruction in groups A and B, respectively (p=0.14). The 20-month primary, assisted, and secondary patency rates and limb salvage rates were 57%, 57%, 81%, and 80% in group A compared to 21%, 23%, 55%, and 82% in group B (p=0.0012, 0.0052, 0.022, and 0.44, resp.).Conclusion. Despite better primary, assisted, and secondary patency rates in patients with a prosthetic infragenicular femoropopliteal bypass embedded in the intercondylar fossa compared to patients with the medial approach, there is no benefit in terms of the limb salvage rate and the number of interventions required to maintain patency of the reconstruction.

scholarly journals The Thermo-Pressure Concept: A New Model in Diabetic Foot Risk Stratification

2021 ◽  
Vol 11 (16) ◽  
pp. 7473
Author(s):  
Sarah Perren ◽  
Cynthia Formosa ◽  
Liberato Camilleri ◽  
Nachiappan Chockalingam ◽  
Alfred Gatt
Keyword(s):  
Diabetic Foot ◽  
Assessment Tool ◽  
Arterial Disease ◽  
Healthy Individuals ◽  
Foot Pressure ◽  
Foot Ulceration ◽  
Group A ◽  
Group B ◽  
Peripheral Arterial ◽  
Group D

Elevated foot pressure and high temperatures have been proposed as predictive factors for diabetic foot ulceration; however, on their own, their predictive value is still questionable. This pilot study hypothesized that combining these two measurements in a thermo-pressure model could result in a more reliable risk assessment tool for providing risk categorization aimed to determine whether there is a correlation between foot plantar pressure and temperature in patients living with diabetes mellitus (DM) when compared with healthy individuals following a 15 min walk. Foot pressure and thermographic images were taken from 48 participants who were categorised into four groups following clinical evaluation into healthy individuals (Group A), living with DM with no complications (Group B), DM with peripheral arterial disease (Group C) and DM patients with neuropathy (Group D). This study demonstrated a positive correlation between pressure and temperature; as pressure increases, so does temperature. This was more pronounced in the groups with DM when compared to the healthy group. More research is warranted to further develop this innovative thermo-pressure model, which could hopefully be more sensitive in categorizing and identifying patients living with DM who are at risk of developing foot ulceration to initiate prompt care.

PT453 Disease Management Interventions For Improving Self-Management In Lower-Limb Peripheral Arterial Disease: A Cochrane Review

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e262
Author(s):  
Sally C. Inglis ◽  
HuiYun Du ◽  
Phillip J. Newton ◽  
Michelle DiGiacomo ◽  
Abdullah Omari ◽  
...  
Keyword(s):  
Disease Management ◽  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Cochrane Review ◽  
Arterial Disease ◽  
Self Management ◽  
Management Interventions ◽  
Peripheral Arterial
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