scholarly journals A novel total body digital photography smartphone application designed to detect and monitor skin lesions: a pilot study

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Nicholas Guido ◽  
Erika L. Hagstrom ◽  
Erin Ibler ◽  
Chantelle Carneiro ◽  
Kelsey A. Orrell ◽  
...  
Keyword(s):  
Decision Making ◽  
High Sensitivity ◽  
Smartphone Application ◽  
Skin Lesions ◽  
Smartphone Applications ◽  
Self Monitoring ◽  
Pigmented Lesions ◽  
Naturally Occurring ◽  
Total Body ◽  
New Skin

<p class="Body">Although some smartphone applications are designed for total body photography (TBP), few offer the specificity that enables self- as well as dermatologist-, detection of new lesions, or change in lesion color or in size as little as 1mm, on an ongoing basis. The aim of this study is to assess the sensitivity of a novel TBP application in the detection of changes to color and size of simulated skin lesions. Twenty-five subjects underwent one study visit. After baseline photography, new artificial markings were made or naturally occurring pigmented lesions located in any anatomical region were enhanced/enlarged, and a second matching set of photographs was then taken. From all 25 subjects, a total of 262 skin markings were evaluable. Of these, 241 (92%) were detected by the app, which resulted in an overall sensitivity of 92%. The high sensitivity establishes the app as capable of providing reliable self-TBP that allows detection and monitoring of new skin lesions or change in both size and color. This method greatly enhances the ability to accomplish ongoing self-monitoring and yet provides quality informing images to the dermatologist to assist in decision-making with the patient. </p>

Self-monitoring and the Use of Affective and Cognitive Reasons in Decision-Making

1999 ◽  
Author(s):  
Andrew L. Geers ◽  
G. Daniel Lassiter ◽  
Katie Stricker
Keyword(s):  
Decision Making ◽  
Self Monitoring

scholarly journals 1138. Script for Pediatrics: Creating a Smartphone Application to Improve Antimicrobial Prescribing

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S405-S405
Author(s):  
Sarah Primhak ◽  
Natasha Pool ◽  
Gayl Humphrey ◽  
Lesley Voss ◽  
Rachel H Webb ◽  
...  
Keyword(s):  
Decision Making ◽  
Antimicrobial Stewardship ◽  
Point Of Care ◽  
Smartphone Application ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Duration Of Treatment ◽  
Antibiotic Allergy ◽  
Alternative Agent ◽  
The Impact

Abstract Background When considering antimicrobial stewardship (AMS) interventions, pediatrics is an important and often overlooked group. By 5 years of age, 97% of New Zealand (NZ) children have received antibiotics (median 8 antibiotic courses/child). Prescribing is complex due to age and weight-based adjustments, unpalatable oral preparations and inappropriate allergy labeling. Our tertiary Children’s Hospital has >250 web-based nationally utilized guidelines, 15% including antimicrobials. A point prevalence audit showed only 63% guideline adherence for inpatient antimicrobial prescriptions. We designed an accessible app to bring antibiotic prescribing and antibiotic allergy decision-making to prescribers at point of care. Methods Using local hospital and community guidelines, the national formulary and in consultation with subspecialist teams, 31 algorithms were developed. Each algorithm asked questions including diagnosis, age, antibiotic allergy history and known colonization with-resistant organisms. Results The smartphone app (Script) uses the algorithms to advise on appropriate antimicrobial, dose, route and duration of treatment. Advice regarding IV-oral switch parameters and oral antibiotic choice is provided. If allergy is suspected symptom-based decision-making enables the user to choose an alternative agent or encourages allergy de-labeling. Further AMS occurs in some algorithms when advice is given not to prescribe antimicrobials. Conclusion Script for Pediatrics launched in NZ in March 2019 with >1000 users in the first 6 weeks. The most frequently accessed guidelines are otitis media, pneumonia and meningitis. Smartphone applications with local relevance and the ability to update in real-time may prove important tools, by providing easily accessible and intuitive advice to help support antimicrobial stewardship activities. This intervention has been rapidly adopted by pediatric hospital prescribers. The impact on prescribing in concordance with guidelines, timely intravenous to oral antibiotic switch and allergy de-labeling will be assessed. Disclosures All authors: No reported disclosures.

scholarly journals Development of a Smartphone Application for Dietary Self-Monitoring

2019 ◽  
Vol 6 ◽  
Author(s):  
Jeong Sun Ahn ◽  
Dong Woo Kim ◽  
Jiae Kim ◽  
Haemin Park ◽  
Jung Eun Lee
Keyword(s):  
Smartphone Application ◽  
Self Monitoring

Abstract 159: Exceptional Aggressiveness of CCM3 Phenotype

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Tania J Rebeiz ◽  
Abdul Ghani Mikati ◽  
Darlene Simkhin ◽  
Cornelia Lee ◽  
Amy Akers ◽  
...  
Keyword(s):  
Spontaneous Mutation ◽  
Mutation Screening ◽  
High Sensitivity ◽  
Skin Lesions ◽  
Cerebral Cavernous Malformations ◽  
Cognitive Disability ◽  
Cavernous Malformations ◽  
Patient Advocacy Group ◽  
Sporadic Cases

Introduction: Familial forms of cerebral cavernous malformations (CCM) account for about 1/3 of cases, involving autosomal dominant inheritance at 1 of 3 gene loci. Few studies have examined any special features of the rarest cases with CCM3 (PDCD10 ) mutation at q3, constituting <15 % of probands genotyped by sequential mutation screening, and <2% of CCM cases at large. Hypothesis: We hypothesize that CCM3 cases have unique phenotypic features not recognized in the more common CCM1 and 2 families, or in sporadic cases. Methods: Twelve probands including 17 subjects with confirmed CCM3 mutations were prospectively enrolled through systematic facilitated referral by the patient advocacy group Angioma Alliance. Clinical features were catalogued, including high sensitivity susceptibility weighted imaging (SWI). Rates of overt hemorrhage were determined based on adjudicated criteria. Comparisons were made to systematic literature review of natural history data on non-CCM3 cases. Results: The first overt hemorrhage occurred most often in the 1st decade of life (mean age 5.8). Nine of 17 subjects (52%) suffered 30 overt hemorrhages, with an estimated incidence of 6.7 % /patient/year based on exposure risk since birth, and 17% /patient/year based on risk since first symptom onset. Lesion burden on SWI was exceptionally high, >100 lesions in 28%, and > 20 lesions in 72% of cases, respectively. Adjusted bleed rate was <0.5% /lesion/year. New SWI lesions formed at a rate of 2.7/patient/year in prospective follow-up, and 1.8/patient/year based on years since birth. Scoliosis was found in 47% (an association not recognized previously), skin lesions in 29.4%, and brain tumors in 29.4% of cases, respectively. Cognitive disability affected 47% of cases, mostly in association with high lesion burden. Six of 15 cases with parental screening (40%) represented a spontaneous mutation. Conclusion: CCM3 is exceptionally aggressive compared to other familial and sporadic CCM. High risks of bleeding and cognitive disability mostly reflect severe lesion burden early in life, rather than a higher risk per lesion. These results will inform the design of clinical trials, urgently needed to address this unique CCM cohort.

scholarly journals The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1473 ◽  
Author(s):  
Jose Recio-Rodriguez ◽  
Cristina Agudo Conde ◽  
Maria Calvo-Aponte ◽  
Natividad Gonzalez-Viejo ◽  
Carmen Fernandez-Alonso ◽  
...  
Keyword(s):  
Primary Care ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Nutritional Composition ◽  
Lower Percentage ◽  
Self Monitoring ◽  
Randomized Controlled ◽  
Saturated Fats ◽  
Counseling Group

Background: This study evaluates the effectiveness of adding a diet smartphone application to standard counseling to modify dietary composition over the long term (12 months). Methods: A randomized, controlled, multicenter clinical trial was conducted involving the participation of 833 subjects from primary care clinics (415 to the intervention (counseling + application) group (IG) and 418 to the control (counseling) group (CG)). Both groups were counseled about a healthy diet and physical activity. For the 3-month intervention period, the IG was also trained to use a diet smartphone application that involved dietary self-monitoring and tailored feedback. Nutritional composition was estimated using a self-reported food frequency questionnaire. Results: An analysis of repeated measures revealed an interaction between the group and the percentages of carbohydrates (p = 0.031), fats (p = 0.015) and saturated fats (p = 0.035) consumed. Both groups decreased their energy intake (Kcal) at 12 months (IG: −114 (95% CI: −191 to −36); CG: −108 (95% CI: −184 to −31)). The IG reported a higher percentage intake of carbohydrates (1.1%; 95% CI: 0.1 to 2.0), and lower percentage intakes of fats (−1.0%; 95% CI: −1.9 to −0.1) and saturated fats (−0.4%; 95%CI: −0.8 to −0.1) when compared to the CG. Conclusions: Better results were achieved in terms of modifying usual diet composition from counseling and the diet smartphone application compared to counseling alone. This was evaluated by a self-reported questionnaire, which indicated an increased percentage intake of carbohydrates, and decreased percentage intakes of fats and saturated fats.

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