scholarly journals Characterization of the Teleneurology Patients at the Hospital Las Higueras de Talcahuano—Chile

2020 ◽  
Vol 11 ◽  
Author(s):  
Freddy Constanzo ◽  
Paula Aracena-Sherck ◽  
Lorena Peña ◽  
Mery Marrugo ◽  
Jonathan Gonzalez ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Primary Healthcare ◽  
Significant Contribution ◽  
Number Of Patients ◽  
Ambulatory Patients ◽  
Tertiary Healthcare ◽  
First Time ◽  
Primary Healthcare Centers

Background: Chile has a shortage of medical experts, including neurologists. The remote neurology program at Las Higueras Hospital in Talcahuano (HHT) was implemented in 2015 to decrease the number of patients waiting for their first appointment.Methods: This retrospective study analyzed a cohort of 2,904 ambulatory patients evaluated in the teleneurology program at the HHT between 2015 and 2019 who were referred from 16 primary and 3 tertiary healthcare centers.Results: Out of the 2,904 patients included in the study, 1,020 patients (35%) were male, and 1,884 (65%) were female. In total, 1,346 (46.0%) patients were under 60 years old (408 male and 938 female), and 1,558 (54%) were over 60 years old (612 male and 946 female). The patients were referred to a neurologist in the teleneurology program from different primary healthcare centers (93.5%) and tertiary healthcare centers (6.5%). The most common diseases diagnosed through teleneurology were, in decreasing order, headache (29.4%), Alzheimer's disease and other dementias (15.9%), and epilepsy (11.4%). From July 2018, we analyzed the patients' destination after the first teleneurology consultation. In the cohort of 634 patients who had their first consultation via the teleneurology program, 547 (86.3%) were instructed to continue follow-up via telemedicine.Conclusions: Data from this study show, for the first time in Chile, the significant contribution of the teleneurology program at the HHT to the diagnosis of a broad range of diseases in a substantial number of patients referred from primary and tertiary healthcare centers.

scholarly journals Phenolic Profiling of Flax Highlights Contrasting Patterns in Winter and Spring Varieties

Molecules ◽  
2019 ◽  
Vol 24 (23) ◽  
pp. 4303 ◽  
Author(s):  
Job Tchoumtchoua ◽  
David Mathiron ◽  
Nicole Pontarin ◽  
David Gagneul ◽  
Anne-Isaline van Bohemen ◽  
...  
Keyword(s):  
Linum Usitatissimum ◽  
Comprehensive Analysis ◽  
Coniferyl Alcohol ◽  
Preparative Hplc ◽  
Omega 3 ◽  
Standard Analysis ◽  
Plant Grown ◽  
First Time

Flax (Linum usitatissimum) is a plant grown in temperate regions either for its fiber or for its seeds, which are rich in the essential fatty acid omega-3. It is also well known as a source of medicinal compounds. The chemical composition of its leaves is currently poorly described. In order to fill this gap, we have conducted a comprehensive analysis of flax leaf metabolome. The exploration of the metabolome allowed the characterization of compounds isolated for the first time in flax leaves. These molecules were isolated by preparative HPLC and then characterized by NMR, LC-MS and standard analysis. This work extended our picture of C-glycosyl-flavonoids and coniferyl alcohol derivatives accumulated in flax. The follow-up of the content of these different metabolites via UPLC-MS revealed significant accumulation differences in spring and winter flax leaves. In particular, two methylated C-glycosylflavonoids (swertisin and swertiajaponin) were the most abundant phenolic compounds in winter flax whereas they were not detected in spring flax. This result suggests that these 2 compounds are involved in cold stress tolerance in flax.

scholarly journals The Impact Of Frailty On Admission To Home Care Services And Nursing Homes: Eight-Year Follow-Up Of A Community-Dwelling, Older Adult, Spanish Cohort

2020 ◽  
Author(s):  
Francisco Cegri ◽  
Francesc Orfila ◽  
Rosa M Abellana ◽  
María Pastor-Valero
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Home Care ◽  
Primary Healthcare ◽  
Daily Living ◽  
Community Dwelling ◽  
Older Age ◽  
Age Dependence ◽  
Primary Healthcare Centers

Abstract Background The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥ 70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods Study design: prospective, multicenter, cohort study in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). Participants: the cohort was made up of 616 individuals. Data collection: baseline interview included a multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, telephone contacts, and the Central Registry of Catalonia for mortality. Statistical analysis: a prognostic index for a HC and NH at eight years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine–Gray regression models were used. The internal validity of the predictive models was tested for 150 bootstrap re-samples. Results At baseline, mean age was 76.4 years, 55.5% were women, and 22% lived alone. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate competitive risk models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of the Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of the Daily Living, augmented number of prescriptions, and the presence of social risk. Conclusions Prognostic models based on comprehensive geriatric assessments can predict the need for the commencement of HC and NH admission in community-dwelling older adults. Our findings underline the necessity to measure functional capacity, mobility, number of prescriptions, and social aspects of older adults in primary healthcare centers. In such a setting they can be offered longitudinal holistic assessments so as to benefit from preventive actions in order to remain independent in the community for as long as possible.

scholarly journals Balance and Mobility as Predictors of Post-Stroke Cognitive Impairment

2015 ◽  
Vol 5 (2) ◽  
pp. 203-211 ◽  
Author(s):  
Marie Helene Ursin ◽  
Astrid Bergland ◽  
Brynjar Fure ◽  
Audhild Tørstad ◽  
Arnljot Tveit ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Significant Contribution ◽  
Berg Balance Scale ◽  
Exclusion Criteria ◽  
Timed Up And Go ◽  
Logistic Regression Models ◽  
Health Authorities ◽  
Number Of Patients ◽  
Ischaemic Attack

Background: The number of patients with cognitive impairment following stroke is increasing due to the rise in the number of stroke survivors. Health authorities highlight the need for prediction and early diagnostics. The aims of this study were to investigate if balance and mobility may predict cognitive impairment 1 year after stroke. Methods: The participants were patients with first-ever stroke or transient ischaemic attack (TIA). The exclusion criteria were pre-stroke cognitive impairment and dementia. Measurements of balance comprised the Berg Balance Scale (BBS) and the Figure of Eight test (Fig8). Mobility was measured by maximum walking speed and the Timed Up and Go test. Dementia and mild cognitive impairment were merged into a main outcome: cognitive impairment. Unadjusted and adjusted multivariate logistic regression models were performed. Results: One hundred and eighty subjects performed balance and mobility measures at baseline, and 158 participated in the follow-up; 13 died and 9 did not complete the follow-up. Two variables made a significant contribution in the adjusted analyses (Fig8, BBS). The strongest predictor of cognitive impairment was Fig8 with an odds ratio of 1.06. Conclusion: The results of Fig8 and BBS measured in the acute phase of stroke were predictors of cognitive impairment 1 year later in this cohort of first-ever stroke or TIA.

scholarly journals The Future of the Time Domain with LSST

2011 ◽  
Vol 7 (S285) ◽  
pp. 158-158
Author(s):  
Lucianne M. Walkowicz
Keyword(s):  
Time Domain ◽  
Survey Design ◽  
Ancillary Data ◽  
Event Identification ◽  
Scientific Investigations ◽  
The Time Domain ◽  
First Time

SummaryIn the coming decade LSST's combination of all-sky coverage, consistent long-term monitoring and flexible criteria for event identification will revolutionize studies of a wide variety of astrophysical phenomena. Time-domain science with LSST encompasses objects both familiar and exotic, from classical variables within our Galaxy to explosive cosmological events. Increased sample sizes of known-but-rare observational phenomena will quantify their distributions for the first time, thus challenging existing theories. Perhaps most excitingly, LSST will provide the opportunity to sample previously untouched regions of parameter space. LSST will generate ‘alerts’ within 60 seconds of detecting a new transient, permitting the community to follow up unusual events in greater detail. However, follow-up will remain a challenge as the volume of transients will easily saturate available spectroscopic resources. Characterization of events and access to appropriate ancillary data (e.g. from prior observations, either in the optical or in other passbands) will be of the utmost importance in prioritizing follow-up observations. The incredible scientific opportunities and unique challenges afforded by LSST demand organization, forethought and creativity from the astronomical community. To learn more about the telescope specifics and survey design, as well as obtaining a overview of the variety of the scientific investigations that LSST will enable, readers are encouraged to look at the LSST Science Book: http://www.lsst.org/lsst/scibook. Organizational details of the LSST science collaborations and management may be found at http://www.lsstcorp.org.

P994Does AF always beget AF? Retrospective study in patients with complex cardiac devices

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Briosa E Gala ◽  
M Pope ◽  
M Leo ◽  
T R Betts
Keyword(s):  
Retrospective Study ◽  
Remote Monitoring ◽  
Binary Classification ◽  
Statistical Significance ◽  
First Episode ◽  
Cardiac Devices ◽  
Direct Current Cardioversion ◽  
Number Of Patients ◽  
The Mean

Abstract Introduction Atrial fibrillation (AF) is conventionally divided in paroxysmal AF (PAF) and persistent AF (PersAF) according to episode duration, with a perceived inevitable progression of the arrhythmia in most patients: "AF begets AF". This dichotomous classification of AF is currently being challenged by continuous monitoring with implantable cardiac monitors and pacemakers which suggest different patterns of AF with considerable variation in AF burden.  Purpose This study sought to examine the long-term progression of AF burden in patients with complex cardiac devices (implantable cardiac defibrillators [ICD] and cardiac resynchronisation therapy-defibrillators [CRT-D]). Methods This retrospective study examined the weekly AF burden in patients with ICDs and CRT-Ds and on remote monitoring between January 2010 and July 2019.  All transmissions and electrograms were assessed for the presence of AF lasting more than 6 minutes.  The first episode of AF determined was considered follow-up year 0.  PersAF was defined as a weekly AF burden of 100%. Medical records were reviewed for baseline characteristics at the time of the first episode of AF and interventions that may affect burden such as direct current cardioversion (DCCV) and catheter ablations. Results Of 331 patients on remote monitoring, 106 (32%) had evidence of AF. Of these, 89% were male, age 64 ± 12 years, BMI 30 ± 6 kg/m2, LA diameter 4.5 ± 0.8 cm, 58% had an ICD, 10% had previous AF ablation and 27% had antiarrhythmic medication. Forty-six (43%) had PersAF and 60 (57%) had PAF over a total follow-up of 393 patient years (mean follow-up 4.6. ±2.1).  The mean AF burden  was 1.2 ± 4.4% in PAF and 66.4 ± 35.3% in PersAF at the end of the first year of follow-up. When compared to year 1, the mean annual AF burden did not increase in the PAF and PersAF groups. Moreover, the PersAF patients had a significant reduction in the mean annual AF burden up to year 7 of follow-up. In year 8, the mean annual AF burden remained below year 1; however, due to a low number of patients (5) it did not reach statistical significance (mean difference 15.1%, p = 0.06) . To further assess individual progression in PersAF patients, the annual AF burden was subdivided in 4 categories (<25%, 25%-50%, 50%-75% and >75%). In 30 (65%) patients it remained unchanged, in 5(11%) it worsened and in 11 (24%) it improved (Figure ). Moreover, 35 (76%) patients reverted to sinus rhythm following their first episode of PersAF (5 following DCCV and 2 after catheter ablation).  Conclusions In this cohort,  the mean AF burden did not increase; in fact, we observed a significant reduction in patients with PersAF despite a low rate of interventions. These findings reinforce the emerging concept of AF as a heterogenous disease with various phenotypes that challenge the current simplistic binary classification. Abstract Figure

scholarly journals International Multicenter Validation Study of the SAGIT ® Instrument in Acromegaly

2021 ◽  
Author(s):  
Andrea Giustina ◽  
Marcello D Bronstein ◽  
Philippe Chanson ◽  
Stephan Petersenn ◽  
Felipe F Casanueva ◽  
...  
Keyword(s):  
Disease Control ◽  
Regression Tree ◽  
Classification And Regression Tree ◽  
Global Evaluation ◽  
Therapeutic Decision ◽  
Treatment Change ◽  
International Guidelines ◽  
Number Of Patients

Abstract Context The SAGIT ® instrument (SAGIT) has been developed to enable accurate characterization of acromegaly disease activity. Objective Evaluate the ability of SAGIT to discriminate between acromegaly disease control status. Design Multicenter, non-interventional, prospective and retrospective, longitudinal study. Settings and Patients Academic and private clinical practice sites; patients aged ≥18 years with diagnosis of controlled (n=109) or non-controlled (n=105) acromegaly, assessed by clinical global evaluation of disease control (CGE-DC) questionnaire, investigator therapeutic decision and international guidelines. Control status was not determined at baseline for 13 patients. As a limited number of patients were enrolled retrospectively (N=9), all presented analyses are based on the prospective population (N=227). Methods Patients were assessed over a two-year follow-up period. Classification and regression tree (CART) analyses were performed to investigate how the SAGIT components at baseline (signs/symptoms [S], associated comorbidities [A], GH levels [G], IGF-1 levels [I], tumor features [T]) discriminate between controlled and non-controlled acromegaly. Results Baseline mean subscores S, G, I and T, were significantly lower in patients with CGE-DC controlled acromegaly compared with CGE-DC non-controlled acromegaly. SAGIT components I and G for CGE-DC and S, A, G, I and T for the clinician’s therapeutic decision were retained by CART analyses. For international guidelines, only SAGIT component I was retained. The risk for undergoing at least one treatment change during the study for patients with CGE-DC non-controlled acromegaly relative to CGEDC controlled acromegaly was 3.44 times greater. Conclusion The SAGIT instrument is a valid and sensitive tool to comprehensively and accurately assess acromegaly severity.

scholarly journals First time traumatic anterior shoulder dislocation: Will it always result in recurrent shoulder dislocation in all patients?

2020 ◽  
Vol 27 (04) ◽  
pp. 695-699
Author(s):  
Faaiz Ali Shah ◽  
Mian Amjad Ali ◽  
Naeemullah
Keyword(s):  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Rehabilitation Program ◽  
Monthly Interval ◽  
Anterior Shoulder Dislocation ◽  
Number Of Patients ◽  
Traumatic Anterior Shoulder Dislocation ◽  
Recurrent Shoulder Dislocation ◽  
First Time

Objectives: To determine the frequency of recurrent shoulder dislocation after first time traumatic anterior shoulder dislocation treated non operatively. Study Design: Prospective observational cohort study. Setting: Department of Orthopedics and Traumatology Lady Reading Hospital Peshawar. Period: 25th May 2011 to 25th December 2018. Material & Methods: Patients of all ages and both gender with first time. Traumatic anterior shoulder dislocation meeting the inclusion criteria were included in the study. In the included subjects shoulder joint was relocated under general anesthesia and immobilized in a poly sling for four weeks followed by supervised physiotherapy and rehabilitation program without any surgical stabilization of the shoulder joint. All these patients were instructed for follow up at monthly interval or before if recurrence occurred. Results: A total of 52 patients with mean age 35±9.4 years (range 16-55 years) were enrolled in our study. Male patients were 43(82.6%) while female patients were 9(17.3%). Right sided dislocation was noted in 38(73%) and left in 14(26.9%). Recurrent shoulder dislocation was reported in 32(61.5%) patients during a minimal follow up period of three years. Most (46.8%, n=15) of the patients with recurrent shoulder dislocation were 30 years of age or below. Conclusion: First time traumatic anterior shoulder dislocation treated non operatively not always result in recurrent shoulder dislocation in all patients. However a large number of patients and particularly younger patients suffered recurrence.

scholarly journals Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey

2019 ◽  
Vol 16 (9) ◽  
pp. 1625 ◽  
Author(s):  
Rosalia Santesmases-Masana ◽  
Luis González-de Paz ◽  
Elvira Hernández-Martínez-Esparza ◽  
Belchin Kostov ◽  
Maria Dolors Navarro-Rubio
Keyword(s):  
Heart Failure ◽  
Health Literacy ◽  
Chronic Heart Failure ◽  
Primary Healthcare ◽  
Self Care ◽  
Cross Sectional ◽  
Heart Failure Patients ◽  
Care Practices ◽  
Primary Healthcare Centers

Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.

Characterization of Depression Among Patients At Urban Primary Healthcare Centers in Oman

2015 ◽  
Vol 49 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Asthma Al-Salmani ◽  
Tahara Juma ◽  
Arwa Al-Noobi ◽  
Yahya Al-Farsi ◽  
Najlaa Jaafar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Primary Healthcare Centers
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