Implementation of Telemedicine Specialized Appointment in Eastern Amazon State of Pará

2019 ◽  
Vol 6 (2) ◽  
pp. 126-136
Author(s):  
Gustavo Celeira De Sousa ◽  
Rodrigo Luiz Martins Pantoja ◽  
Ana Carolina De Castro Ribeiro Cabeça ◽  
Kleber Pinto Ladislau ◽  
Ramona Carvalho Barros ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Health Centers ◽  
Health Access ◽  
Medical Work ◽  
Urban Centers ◽  
Telemedicine System ◽  
Major Health ◽  
Medical Consultations ◽  
The Times ◽  
Universal Health

Introduction: Telemedicine program was first implemented in Brazil in 2007, by Health Ministry Decret, in which was set the goals of the program: permanent education and changes in medical work. After some reformulations of the program it was also included primary health care based specialized medical consultations, through the guarantee of health services such as teleconsultancy, telediagnosis and tele education; centered at universities and major health centers, after what it became to be known as Nacional Program Telehealth Brazil Network. Brazil’s North Region is the largest amongst all of its regions (3 853 676,948 km²) but with the smaller demographic density (4,72 hab./‎km²), also with irregular populational distribution, which is concentrated at shore or riverside urban centers. Telemedicine was implemented as a way in trying to provide universal health access to the whole population. Method: Various Municipal Health Secretariats underwent agreements in order to establish a integrated and specialized medical consultancy network, using teleconference technologies and online pronctuary to accomplish it, allowing a specialized doctor located at the capital to guide and observe a generalist medic through the physical examination and therapeutic conduction. The system kept register of consultations to the ones who had its secret passwords. Results/Discussion: Telemedicine system was able to cover an area of up to 36.133.135 km2, allow up to 674.770 people to have access to specialized health, perform 1125 medical consultations in seven months; which diminished the queue from five years to three months of waiting for clinical examination. In addition, the consultations have kept a good quality for the whole health team and the patients, who could receive correct diagnosis on the first consult most of the times, as well as received longitudinal attendance. Conclusion: Telemedicine is an effective, secure and revolutionary alternative to grant universal health access to distant populations.

A Promising Health Care Reform in Greece

2011 ◽  
Vol 3 (2) ◽  
pp. 23-27 ◽  
Author(s):  
Zoe Boutsioli
Keyword(s):  
Health Care ◽  
Health Care Expenditures ◽  
Health Centers ◽  
Hospital Services ◽  
Major Health ◽  
Hospital Units ◽  
Primary Health ◽  
Effective Efficiency ◽  
Care Problems ◽  
Specific Health

The Greek Ministry of Health has decided to reform hospital services, due to high cost and low services offered and a part of health care expenditures is wasted. The Minister of Health, Mr. Andreas Loverdos has enacted a law for the Greek health care system which include 3 major health reforms: the co-management of hospital units, taking either the type of ‘shared Manager’ or ‘shared Board of Directors,’ the transformation of some general hospitals/health centers or specialized hospitals that present low effective/efficiency rates into either primary health care units or day clinics for specific health care problems, and the merging of similar departments/clinics and/or laboratories either in a hospital or among two or more hospitals that are in the neighborhood. From these reforms, it is estimated that more than 150 million Euro will be saved from these reforms during the 4-year period 2012-2015.

scholarly journals Management of a Difficult-to-Treat Diabetic Foot Wound Complicated by Osteomyelitis: A Case Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Maram Alkhatieb ◽  
Hatan Mortada ◽  
Hattan Aljaaly
Keyword(s):  
Diabetic Foot ◽  
Correct Diagnosis ◽  
Posterior Part ◽  
Holistic Approach ◽  
Diabetic Patients ◽  
Major Health ◽  
History Of ◽  
Major Health Issue

Introduction. Diabetic ulcers are a major health issue worldwide, causing significant economic burdens and affecting both the patient and the society as a whole. Predisposing factors in diabetic patients, known as the pathogenic triad, comprise trauma, ischemia, and neuropathy. Regardless of the cause, correct diagnosis and prompt treatment are essential in the management of leg ulcers. Case History. We report a case of a 51-year-old male patient, with a known history of type 2 diabetes mellitus who presented to our hospital with a history of two ulcers, one that he was mainly complaining of, which was actively infected and located at the posterior part of the distal left leg, and the second, dry ulcer caused by unrecognized trauma, located on the heel of the same limb. Magnetic resonance imaging showed osteomyelitis and degenerative changes in the calcaneonavicular and tarsal joints. The patient underwent multiple sessions of excisional debridement. He was started on negative pressure wound therapy with some improvements. However, after skin graft failure, Nanoflex powder was used, leading to complete wound closure within one month of treatment. Conclusion. A multidisciplinary holistic approach must be used when treating diabetic foot ulcers. Different modalities and sessions of debridement should be performed after optimizing the general condition of the patient.

Bladder pain syndrome

2017 ◽  
Author(s):  
Magnus Fall
Keyword(s):  
Treatment Options ◽  
Correct Diagnosis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Clinical Syndrome ◽  
Personal Life ◽  
Medical Community ◽  
Bladder Pain ◽  
Profound Impact ◽  
Medical Consultations

Bladder pain syndrome has a profound impact on the patients’ physical, professional, and personal life. Generally, recognition of this clinical syndrome is hampered by insufficient expertise in the medical community. The correct diagnosis is often delayed by several years and may be preceded by multiple medical consultations and treatment attempts. Still, this is one of the most painful, non-malignant conditions to be encountered in urology and it is probably more common than generally believed. Problems as to diagnosis, phenotyping, terminology, and management persist, but during the last few years there has been increasing activity to resolve those issues. In this chapter, symptoms, findings, and treatment options are outlined.

Out-of-Pocket Health Expenditures Among Insured and Uninsured Patients in Vietnam

2019 ◽  
Vol 31 (3) ◽  
pp. 210-218 ◽  
Author(s):  
Nguyen Duc Thanh ◽  
Bui Thi My Anh ◽  
Chu Huyen Xiem ◽  
Hoang Van Minh
Keyword(s):  
Outpatient Care ◽  
Inpatient Care ◽  
Health Care Services ◽  
Health Facilities ◽  
Least Square ◽  
Health Centers ◽  
Health Coverage ◽  
District Health ◽  
District Hospitals ◽  
Universal Health

Out-of-pocket expenditure/payment (OOP) is one of the indicators measuring the achievement of Universal Health Coverage. This article aimed to compare OOP among the insured and uninsured for their outpatient and inpatient health care services. The data of 6710 individuals using outpatient care and 924 individuals using inpatient care at 78 district hospitals and 246 commune health centers in 6 provinces from the World Bank survey, “The 2015 Vietnam District and Commune Health Facility,” were used for analysis. In the ordinary least square model, the estimated coefficient of the insurance status variable suggested that insurance reduced OOP by 31.1% for outpatient care and 31.5% for inpatient care of the insured as compared with the uninsured ( P <0.001). For outpatient care, insurance reduced OOP more for those enrollees using commune health centers than those using district health facilities, 42.3% and 20.2%, respectively. For inpatient care at district health facilities, insurance reduced OOP by 34.9% as compared with the uninsured ( P <0.001). The study suggested that more active solutions should be created to promote the universal health insurance in Vietnam.

scholarly journals Care seeking for children with fever/cough or diarrhoea in Nepal: equity trends over the last 15 years

2017 ◽  
Vol 45 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Mats Målqvist ◽  
Chahana Singh ◽  
Ashish Kc
Keyword(s):  
Time Trends ◽  
Health Access ◽  
Care Seeking ◽  
Health Coverage ◽  
Economic Determinants ◽  
Childhood Illnesses ◽  
Poor Households ◽  
Multiple Indicator Cluster Survey ◽  
Multiple Indicator ◽  
Universal Health

Aims: Childhood illnesses such as diarrhoea and pneumonia remain major contributors to child mortality globally and need to be continually targeted in pursuit of universal health coverage. This study analyses time trends in the prevalence of fever/cough and diarrhoea in Nepal and applies an equity lens in order to identify disadvantaged groups. Methods: Data from the Nepal Demographic Health Surveys of 2001, 2006, and 2011, together with data from the most recent Multiple Indicator Cluster Survey of 2014 performed in Nepal, were utilized for analysis. Results: Analyses revealed improvements (lower prevalence) of diarrhoea and fever/cough in children under five in Nepal over the last 15 years, with an equitable distribution of symptoms over socio-economic determinants. There was, however, a marked and maintained inequity in care seeking for these symptoms, with less educated mothers and those from poor households being only approximately half as likely to seek care for their children. Conclusions: Results highlight the persisting need for targeting care-seeking and societal barriers to treatment in order to achieve universal health access.

scholarly journals The Anticipation of Crime and Corruption Problems Due to the Expansion of Telemedicine: A Study Based on the Korea Medical Crime Investigation System

2021 ◽  
Vol 9 ◽  
Author(s):  
Lee Dongkyu
Keyword(s):  
Health System ◽  
Telemedicine System ◽  
Current Health ◽  
Crime Investigation ◽  
The Times

The telemedicine system, which has been gradually introduced, has changed dramatically with the outbreak of COVID-19. Now, with the development of related laws and technologies, the introduction of telemedicine will be further accelerated, and like the advent of smartphones, this will become an unstoppable trend of the times. However, just as there are various crimes and corruption problems in the current health system, the introduction of telemedicine may bring other problems. Therefore, it is important to anticipate the types of corruption or crimes that will occur with the introduction of telemedicine. And based on these expectations, we will have an opportunity to properly prepare for the various problems associated with telemedicine.

Toxocariasis in Children: An Update on Clinical Manifestations, Diagnosis, and Treatment

2017 ◽  
Vol 12 (04) ◽  
pp. 222-227 ◽  
Author(s):  
Manar Ramadan ◽  
Nagwa El-Sayed
Keyword(s):  
Immune Response ◽  
Correct Diagnosis ◽  
Parasitic Infection ◽  
Clinical Manifestations ◽  
Infected Group ◽  
Diagnosis And Treatment ◽  
Positive Serology ◽  
Major Health ◽  
Neglected Disease ◽  
Human Infections

AbstractToxocariasis, a parasitic infection, carries a major health risk in children, especially in the developing countries. Children are the most infected group because of their undeveloped immune system, their higher exposure to infection, and the frequency of reinfections depending on the factors related to their hygienic and behavioral habits. Many human infections are asymptomatic, with only eosinophilia and positive serology. However, several complications were associated with this neglected disease. These complications depend on the organs invaded by migrating Toxocara larvae, the degree of the larvae burden, and the strength of the host immune response. This review aims at giving an update on clinical manifestations, diagnosis, and treatment of toxocariasis in children. The pediatricians should merge this information into their clinical diagnosis to defeat this neglected disease by establishing the correct diagnosis and treatment.

scholarly journals Seroprevalence of toxoplasmosis in a low-income community in the São Paulo municipality, SP, Brazil

2006 ◽  
Vol 48 (3) ◽  
pp. 167-170 ◽  
Author(s):  
Fabio de Moraes Francisco ◽  
Silvio Luís Pereira de Souza ◽  
Solange Maria Gennari ◽  
Sonia Regina Pinheiro ◽  
Vanessa Muradian ◽  
...  
Keyword(s):  
Low Income ◽  
Antibody Test ◽  
Sao Paulo ◽  
Health Centers ◽  
São Paulo ◽  
Urban Centers ◽  
Low Socioeconomic ◽  
Serum Titer ◽  
Indirect Immunofluorescent ◽  
Immunofluorescent Antibody Test

Toxoplasmosis is one of the most common zoonoses worldwide. The seroprevalence for T. gondii in human population from Brazil might range from 40 to 80%. The aim of this paper was to study the seroprevalence of T. gondii infection in children from age one to 15 living in a low socioeconomic community, named community of Jardim São Remo in the year of 2002. The community is located in the West area of São Paulo municipality, São Paulo State, Brazil. Antibodies to T. gondii were found in 110 (32.4%, CI 95%: 27.5 - 37.7) of the 339 children tested with indirect immunofluorescent antibody test. The titration of the samples revealed 29 children with serum titer equal to 16, 14 children with 32, 18 children with 64, 21 children with 128, 20 children with 256 and eight children with serum titer > 512. The age dependence of the prevalence of T. gondii infection and the association between seroprevalence for T. gondii and seroprevalence for T. canis suggest that the infection is chiefly postnatal. Seroconversion in infant population of community Jardim São Remo occurs in children as young as two years old, earlier than in the children attended at health centers of São Paulo city. The seroprevalence of T. gondii in children from Jardim São Remo was compared to the prevalence in children from other urban centers of Brazil.

scholarly journals The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

2015 ◽  
Vol 105 (3) ◽  
pp. 1067-1104 ◽  
Author(s):  
Martha J. Bailey ◽  
Andrew Goodman-Bacon
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Community Health Centers ◽  
Health Centers ◽  
Older Americans ◽  
Access To Primary Care ◽  
One Year ◽  
Universal Health ◽  
Medicine Community ◽  
Percent Decrease

This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance. (JEL H75, I12, I13, I18, I32, I38, J14)

scholarly journals Epithelioid hemangioendothelioma: an overview and update on a rare vascular tumor

2014 ◽  
Author(s):  
Angela Sardaro ◽  
Lilia Bardoscia ◽  
Maria Fonte Petruzzelli ◽  
Maurizio Portaluri
Keyword(s):  
Poor Prognosis ◽  
Therapeutic Option ◽  
Correct Diagnosis ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Morphological Data ◽  
Vascular Tumors ◽  
Vascular Differentiation ◽  
The Times ◽  
One Year

Epithelioid hemangioendothelioma is a rare vascular tumor, described for the first time in 1975 by Dail and Liebow as an aggressive bronchoalveolar cell carcinoma. The etiology is still a dilemma. Studies about suggestive hypothesis are ongoing. Most of the times it affects lung, liver and bones, although this kind of tumor may involve the head and neck area, breast, lymph nodes, mediastinum, brain and meninges, the spine, skin, abdomen and many other sites. Because of its heterogeneous presentation, as it represents less than 1% of all the vascular tumors, it is often misdiagnosed and not suitably treated, leading to a poor prognosis in some cases. Over 50-76% of the patients are asymptomatic. A small number of them complains respiratory symptoms. Bone metastases might cause pathological fractures or spine compression, if they arise in vertebrae. Imaging is necessary to determine morphological data, the involvement of surrounding tissues, and potentially the cleavage plan. It is important to recognize the expression of vascular markers (Fli-1 and CD31 are endothelial-specific markers), and the microscopic evidence of vascular differentiation to make a correct diagnosis, as many pulmonary diseases show multiple nodular lesions. Because of its rarity, there is no standard for treatment. We focused on radiotherapy as a good therapeutic option: despite the poor prognosis, evidence is in favor of radiotherapy which offers local pain control with good tolerance and better quality of life at least at a one-year follow-up in most of cases. Further studies are needed to establish the standard radiation dose to be used for locoregional control of such a complex and extremely rare disease.

Sign in / Sign up

Export Citation Format

Share Document