scholarly journals A Telemedicine Service System Exploiting BT/BLE Wireless Sensors for Remote Management of Chronic Patients

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 13 ◽  
Author(s):  
Massimiliano Donati ◽  
Alessio Celli ◽  
Alessio Ruiu ◽  
Sergio Saponara ◽  
Luca Fanucci
Keyword(s):  
Chronic Diseases ◽  
Wireless Sensors ◽  
Clinical Status ◽  
National Health System ◽  
Clinical Information ◽  
Portable Devices ◽  
Chronic Patients ◽  
Telemedicine Service ◽  
Developed Country ◽  
Number Of Patients

The management of the increasing number of patients affected by cardiovascular, pulmonary, and metabolic chronic diseases represents a major challenge for the National Health System (NHS) in any developed country. Chronic diseases are indeed the main cause of hospitalization, especially for elderly people, leading to sustainability problems due to the huge amount of resources required. In the last years, the adoption of the chronic care model (CCM) as assistive model improved the management of these patients and reduced the related healthcare costs. The diffusion of wireless sensors, portable devices and connectivity enables to implement new information and communication technology (ICT)-based innovative applications to further improve the outcomes of the CCM. This paper presents a telemedicine platform for data acquisition, distribution, processing, presentation, and storage, aimed to remotely monitor the clinical status of chronic patients. The proposed solution is based on monitoring kits, with wireless Bluetooth (BT)/ Bluetooth low energy (BLE) sensors and a gateway (i.e., smartphone or tablet) connected to a web-based cloud application that collects and makes available the clinical information to the medical staff. The platform allows clinicians and practitioners to monitor at distance their patients, according to personalized treatment plans, and to act promptly in case of aggravations, reducing hospitalizations and improving patients’ quality of life.

scholarly journals Research on Key Technologies of Personalized Intervention for Chronic Diseases Based on Case-Based Reasoning

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Lin Zhang ◽  
Ping Qi
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Case Based Reasoning ◽  
Chronic Patients ◽  
Number Of Patients ◽  
Key Technologies ◽  
The Times ◽  
Case Organization ◽  
Personalized Intervention ◽  
Case Based

In recent years, with the acceleration of industrialization, urbanization, and aging process, the number of patients with chronic diseases in the world is increasing year by year. In China, the number of chronic diseases has increased tenfold in 10 years. The percentage of the disease burden in the whole society accounts for 79.4%. Chronic diseases have become the top killer for Chinese people’s health. However, for chronic diseases, prevention is more important than treatment. It is the best way to keep healthy. Therefore, health intervention is the key to prevent chronic diseases. Especially now, with the spread of COVID-19 pandemic, reducing the times of hospital check-ups and treatments for chronic patients is practically significant for releasing the stress on medical staffs and decreasing the rate of transmission and infection of COVID-19. In this paper, case-based reasoning (CBR) technology is used to assist personalized intervention for chronic diseases, and the key technologies of personalized intervention for chronic diseases based on case-based reasoning are proposed. The case organization, case retrieval, and case retention techniques of CBR technology in chronic disease personalized intervention are designed, and the calculation of interclass dispersion is added to the distribution of feature words, which is used to describe the distribution of feature attributes in different categories of cases. It provides an effective method for the establishment of personalized intervention model for chronic disease.

Computer-Aided Diagnosis in Jaundice: Comparison of Knowledge-based and Probabilistic Approaches

1996 ◽  
Vol 35 (01) ◽  
pp. 41-51 ◽  
Author(s):  
F. Molino ◽  
D. Furia ◽  
F. Bar ◽  
S. Battista ◽  
N. Cappello ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Information ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Clinical Documentation ◽  
Data Set ◽  
Knowledge Based ◽  
Number Of Patients ◽  
Support Tools ◽  
Aided Diagnosis

AbstractThe study reported in this paper is aimed at evaluating the effectiveness of a knowledge-based expert system (ICTERUS) in diagnosing jaundiced patients, compared with a statistical system based on probabilistic concepts (TRIAL). The performances of both systems have been evaluated using the same set of data in the same number of patients. Both systems are spin-off products of the European project Euricterus, an EC-COMACBME Project designed to document the occurrence and diagnostic value of clinical findings in the clinical presentation of jaundice in Europe, and have been developed as decision-making tools for the identification of the cause of jaundice based only on clinical information and routine investigations. Two groups of jaundiced patients were studied, including 500 (retrospective sample) and 100 (prospective sample) subjects, respectively. All patients were independently submitted to both decision-support tools. The input of both systems was the data set agreed within the Euricterus Project. The performances of both systems were evaluated with respect to the reference diagnoses provided by experts on the basis of the full clinical documentation. Results indicate that both systems are clinically reliable, although the diagnostic prediction provided by the knowledge-based approach is slightly better.

Chronic Patients’ Satisfaction with the Medical Aid

2020 ◽  
pp. 34-38
Author(s):  
Yekaterina Grigoryeva ◽  
Mariya Yeremina ◽  
Galina Bochkareva
Keyword(s):  
Medical Care ◽  
Chronic Diseases ◽  
Structural Component ◽  
Comprehensive Assessment ◽  
Chronic Patients ◽  
Medical Aid ◽  
Patients Satisfaction ◽  
Medical Institutions

Population’s satisfaction with medical care has recently become an important structural component of the comprehensive assessment of the healthcare activities. The satisfaction is subjectively determined which makes it possible to assess the level of the population’s satisfaction with medical care. The sociological survey is recognised as the most informative method of study. The article provides the results of study of satisfaction with medical care of the respondents suffering from chronic diseases and followed up at the medical institutions of Saratov that has been conducted by the authors.

Dynamics of T Cells Repertoire During Trypanosoma cruzi Infection and its Post-Treatment Modulation

2019 ◽  
Vol 26 (36) ◽  
pp. 6519-6543 ◽  
Author(s):  
Adriana Egui ◽  
Paola Lasso ◽  
Elena Pérez-Antón ◽  
M. Carmen Thomas ◽  
Manuel Carlos López
Keyword(s):  
Immune Response ◽  
Trypanosoma Cruzi ◽  
Chagas Disease ◽  
Cardiac Tissue ◽  
Acute Infection ◽  
Clinical Status ◽  
Chronic Phase ◽  
Parasite Load ◽  
Chronic Patients ◽  
Cruzi Infection

Chagas disease courses with different clinical phases and has a variable clinical presentation and progression. The acute infection phase mostly exhibits a non-specific symptomatology. In the absence of treatment, the acute phase is followed by a chronic phase, which is initially asymptomatic. This chronic asymptomatic phase of the disease is characterized by a fragile balance between the host’s immune response and the parasite replication. The loss of this balance is crucial for the progression of the sickness. The virulence and tropism of the T. cruzi infecting strain together to the inflammation processes in the cardiac tissue are the main factors for the establishment and severity of the cardiomyopathy. The efficacy of treatment in chronic Chagas disease patients is controversial. However, several studies carried out in chronic patients demonstrated that antiparasitic treatment reduces parasite load in the bloodstream and leads to an improvement in the immune response against the Trypanosoma cruzi parasite. The present review is mainly focused on the cellular patterns associated to the clinical status and the evolution of the disease in chronic patients, as well as the effectiveness of the treatment related to T. cruzi infection control. Therefore, an emphasis is placed on the dynamics of specific-antigens T cell subpopulations, their memory and activation phenotypes, their functionality and their contribution to pathogenesis or disease control, as well as their association with risk of congenital transmission of the parasite.

scholarly journals Does Online Community Participation Contribute to Medication Adherence? An Empirical Study of Patients with Chronic Diseases

2021 ◽  
Vol 18 (10) ◽  
pp. 5100
Author(s):  
Jyh-Jeng Wu ◽  
Yueh-Mei Chen ◽  
Paul C. Talley ◽  
Kuang-Ming Kuo
Keyword(s):  
Medication Adherence ◽  
Chronic Diseases ◽  
Online Communities ◽  
Emotional Support ◽  
Self Efficacy ◽  
Online Community ◽  
Healthcare Professionals ◽  
Informational Support ◽  
Chronic Patients ◽  
The Relationship

Effectively improving the medication adherence of patients is crucial. Past studies focused on treatment-related factors, but little attention has been paid to factors concerning human beliefs such as trust or self-efficacy. The purpose of this study is to explore the following aspects of patients with chronic diseases: (1) The relationship between emotional support, informational support, self-efficacy, and trust; (2) the relationship between self-efficacy, trust, and medication adherence; and, (3) whether chronic patients’ participation in different types of online communities brings about significant statistical differences in the relationships between the abovementioned variables. A questionnaire survey was conducted in this study, with 452 valid questionnaires collected from chronic patients previously participating in online community activities. Partial Least Squares-Structural Equation Modeling analysis showed that emotional support and informational support positively predict self-efficacy and trust, respectively, and consequently, self-efficacy and trust positively predict medication adherence. In addition, three relationships including the influence of emotional support on trust, the influence of trust on medication adherence, and the influence of self-efficacy on medication adherence, the types of online communities result in significant statistical differences. Based on the findings, this research suggests healthcare professionals can enhance patients’ self-efficacy in self-care by providing necessary health information via face-to-face or online communities, and assuring patients of demonstrable support. As such, patients’ levels of trust in healthcare professionals can be established, which in turn improves their medication adherence.

Consensus document on radiotherapy in patients with implantable pacemakers and cardioverter – defibrilators

2018 ◽  
Vol 2 (47) ◽  
pp. 27-31
Author(s):  
Lidia Chmielewska-Michalak ◽  
Ewelina Konstanty ◽  
Przemysław Mitkowski
Keyword(s):  
Current Knowledge ◽  
Clinical Status ◽  
Electronic Devices ◽  
Heart Rhythm ◽  
Complex Care ◽  
Consensus Document ◽  
Cardiac Implantable Electronic Devices ◽  
Number Of Patients ◽  
High Level ◽  
Emergency Mode

The number of patients with cardiac implantable electronic devices (CIED), who require oncological management including radiotherapy (RT) is still increasing. According to current knowledge the most frequent device dysfunction related to exposition to ionizing radiation is reprogramming to emergency mode (soft reset). There are uncommon cases of complete, irreversible device damage. CIED dysfunction during RT can be observed in approximately 3% of patients. In majority of cases they are asymptomatic, although in literature there are descriptions of deterioration of clinical status due to bradycardia or exacerbation of heart failure. The most important factor of device malfunction is radiotherapy with photons of energy >10 MV or protons despite energy used. So far there were no cases published with inadequate ICD therapies due to the presence of electromagnetic field interference during RT. Because patients with CIED undergoing RT need complex care to achieve high level of safety, experts of Heart Rhythm Society establish document, published in 2017 which summarized current knowledge about this group of patients. The document contains guidelines on peri-radiotherapy care of patients with CIED.

scholarly journals Quality of care transition and its association with hospital readmission

Aquichan ◽  
2020 ◽  
Vol 19 (4) ◽  
pp. 1-11
Author(s):  
Luciana Andressa Feil Weber ◽  
Maria Alice Dias da Silva Lima ◽  
Aline Marques Acosta
Keyword(s):  
Quality Of Care ◽  
Chronic Diseases ◽  
Hospital Readmission ◽  
Care Transition ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Hospital Management System ◽  
Student’S T ◽  
Inpatient Units

Objective: To evaluate the quality of care transition for patients with chronic diseases and to verify its association with hospital readmission within 30 days after discharge. Method: Cross-sectional epidemiological study of 210 patients with chronic diseases discharged from a hospital in southern Brazil. The Care Transition Measure-15 (CTM-15) instrument was used, through a telephone contact and, in order to identify readmissions within 30 days, the hospital management system was consulted. Student’s t-tests analysis of variance and nonparametric Pearson or Spearman correlation tests were performed. Results: CTM-15 score was 74.7 (± 17.1). No significant association was found between the quality of care transition and hospital readmission. 12.3 % of the patients were readmitted, and 46.2 % of these readmissions were to the emergency service. Conclusions: The quality of the care transition for chronic patients from inpatient units to home, showed a satisfactory score. However, there was no association between the quality of care transition and hospital readmission within 30 days after discharge.

scholarly journals Prevalence of Advance Care Planning Practices Among People with Chronic Diseases in Hospital and Community Settings: A Quasi-Experimental Design

2020 ◽  
Author(s):  
Sarah Yeun-Sim Jeong ◽  
Tomiko Barrett ◽  
Se Ok Ohr ◽  
Peter Cleasby ◽  
Ryan Davey
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Advance Care Planning ◽  
Healthcare Professionals ◽  
Community Setting ◽  
Care Planning ◽  
Community Settings ◽  
Future Health ◽  
Number Of Patients ◽  
Advance Care

Abstract Background: Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care preferences with family members for a time when they are not able to make health care decisions. Despite the promotion of ACP last two decades, and well-known benefits of ACP and a written Advance Care Directive (ACD), they are still underutilised in Australia and across the world. Previous studies have provided some insights, however, an uptake of ACP and prevalence of ACDs in community setting is rarely reported.Methods: The aim of this study was to determine the uptake of ACP and prevalence of ACDs among people with chronic diseases in hospital and community settings. A retrospective medical record audit of eligible patients looking for evidence of ACP was conducted in 16 research sites (eight intervention and eight control) in hospital and community care settings. Participants included those who were admitted to one of the research sites, and who were aged 18 years and over with at least one of nine nominated chronic diseases. The primary outcome measures included the number of patients with evidence of ACP through the following practices: completion of an ACD, appointment of an Enduring Guardian (EG), or completion of a resuscitation plan. Results: The overall prevalence of ACD was 2.8% (n=28) out of 1006 audited records, and only 10 of them were legally binding. The number of EGs legally appointed was 39 (3.9%) across the sites. A total of 151 (15.4%) resuscitation plans were found across the eight hospital sites. 95% (n=144) of the resuscitation plans advised ‘Not-for-resuscitation’. Conclusions: The uptake of ACP is very low. Current medical recording system reveals the challenges in ACP lie in the process of storage, access and execution of the ACDs. Given that having an ACD or EG in place is only useful if the treating physician knows how and where to access the information, it has implications for policy, information system, and healthcare professionals’ education. Trial registration: The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx

scholarly journals Changing in the profile of a patient with acute coronary syndrome without ST-segment elevation over the years 2015-2020

2021 ◽  
Vol 26 (4) ◽  
pp. 94-98
Author(s):  
O.S. Shchukina
Keyword(s):  
Acute Coronary Syndrome ◽  
Clinical Laboratory ◽  
Clinical Status ◽  
High Sensitivity ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Number Of Patients ◽  
Noteworthy Feature ◽  
Risk Patients

The article represents an analysis of the dynamics of the main demographic, clinical, laboratory, and instrumental investigations, final diagnoses of patients who were hospitalized with a diagnosis of acute coronary syndrome without ST segment elevation. A distinctive feature of the work is the recruitment of patients in the same medical institution for different periods of time, which makes possible to trace the dynamics of the clinical profile of patients in the population of Dnipro, a large industrial center of Ukraine. The prevalence of arterial hypertension, chronic heart failure and previous myocardial infarction remained at the same level. In the 2017-2020’s group compared with the 2015’s group, electrocardiographic  manifestations of acute coronary syndrome without ST-segment elevation upon admission were more often detected. Laboratory indicators such as hemoglobin, creatinine and total cholesterol levels remained the same. Another interesting finding is a statistically significant decrease in the number of patients with a reduced glomerular filtration rate according to MDRD (less than 60 ml/min/1.73 m2) in the 2017-2020’s group compared to patients in 2015’s group, although the clinical course of the disease remained practically unchanged. There was a trend towards a worsening of the clinical status and prognosis, namely, increase in the prevalence of atrial fibrillation and diabetes mellitus, increase in the risk of GRACE, as well as increase in the quantity of verified diagnoses of unstable angina, which is most likely associated with the increased use of high-sensitivity troponin. Noteworthy feature is that increase in the quantity of high-risk patients led to an increase in the mean GRACE score.

Gestione delle patologie cardiovascolari croniche in ambiente ambulatoriale: primi dati di un ambulatorio Hub della regione Lombardia

2020 ◽  
pp. 281-288
Author(s):  
Marcella Longo ◽  
Cristiana Valerio
Keyword(s):  
Chronic Diseases ◽  
High Volume ◽  
World Health ◽  
Chronic Illness Care ◽  
Chronic Patients ◽  
The World ◽  
Coronary Syndromes ◽  
Difficult Challenge ◽  
Health Organization

Chronic diseases are the main cause of death and hospitalizations in the world. In 2005 World Health Organization estimated that over 60% of all annual deaths were due to chronic diseases, even with a high neconomic impact. For these reasons chronic illness care is one of the most difficult challenge for the health service: the management of chronic patients needs a different set-ting, as compared with the “hospital – based model” used for acute conditions. In this work, we described the first data of a Hub cardiology out-patient clinic of Azienda Socio Sanitaria Milano Nord, of Lombardia region. Between August 1, 2015 and August 31, 2016, we evaluated 2956 clinical examinations and 4364 instrumental tests. The five main diagnoses were: hypertension (25%), diabetes (17%), chronic coronary syndromes (12%), atrial fibrillation (14%), chronic heart failure (4%). Our results show the high volume of activities of cardiology service and demonstrate the important role of territorial cardiology for chronic cardiovascular disease management.

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