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https://www.readbyqxmd.com/read/28647947/continuous-glucose-monitoring-in-pediatrics-the-gap-between-potential-benefits-and-the-reality-of-utility
#1
Regina L Taddeo, Joanne T Moser, Pantea P Minnock
Continuous Glucose Monitoring (CGM) is rapidly becoming a standard of care in the management of Type 1 diabetes (T1D). Today's devices are nearly as accurate as home glucose meters. They provide glucose data every 5 minutes, alert to high and low blood glucose levels, and allow for remote monitoring of a user's glucose data and patterns. Use of CGM has many benefits including support for tighter glycemic control without increasing the risk for hypoglycemia. There is however emerging evidence of some negative aspects associated with using CGM, which may result in decreased utilization of the device as well as a decline in quality of life, especially in the pediatric population...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28647202/the-current-state-of-teleophthalmology-in-the-united-states
#2
REVIEW
Siddarth Rathi, Edmund Tsui, Nitish Mehta, Sarwar Zahid, Joel S Schuman
Telemedicine services facilitate the evaluation, diagnosis, and management of the remote patient. Telemedicine has rapidly flourished in the United States and has improved access to care, outcomes, and patient satisfaction. However, the use of telemedicine in ophthalmology is currently in its infancy and has yet to gain wide acceptance. Current models of telemedicine in ophthalmology are largely performed via "store and forward" methods, but remote monitoring and interactive modalities exist. Although studies have examined the effects of telemedicine, few reports have characterized its current status...
June 21, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28645310/pth-monitoring-after-total-parathyroidectomy-with-forearm-auto-transplantation-potential-for-spuriously-high-levels-from-grafted-forearm
#3
Diana Khalil, Paul D Kerr
BACKGROUND: We have identified a cause of falsely elevated parathyroid hormone (PTH) levels after total parathyroidectomy with forearm auto-transplantation (TPT-ATx). Our cases highlight the need to draw PTH samples remotely, away from forearm graft sites, to ensure accurate levels. CASE PRESENTATIONS: We report on four patients who were referred to our surgical team at an academic tertiary care center for what was perceived to be recurrent hyperparathyroidism 2-5 years following total parathyroidectomy with auto-transplantation...
June 23, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28642288/ferumoxytol-enhanced-magnetic-resonance-imaging-assessing-inflammation-after-myocardial-infarction
#4
Colin G Stirrat, Shirjel R Alam, Thomas J MacGillivray, Calum D Gray, Marc R Dweck, Jennifer Raftis, William Sa Jenkins, William A Wallace, Renzo Pessotto, Kelvin Hh Lim, Saeed Mirsadraee, Peter A Henriksen, Scott Ik Semple, David E Newby
OBJECTIVES: Macrophages play a central role in the cellular inflammatory response to myocardial infarction (MI) and predict subsequent clinical outcomes. We aimed to assess temporal changes in cellular inflammation and tissue oedema in patients with acute MI using ultrasmallsuperparamagnetic particles of iron oxide (USPIO)-enhanced MRI. METHODS: Thirty-one patients were recruited following acute MI and followed up for 3 months with repeated T2 and USPIO-enhanced T2*-mapping MRI...
June 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28641860/noninvasive-blood-potassium-measurement-using-signal-processed-single-lead-ecg-acquired-from-a-handheld-smartphone
#5
Omar Z Yasin, Zachi Attia, John J Dillon, Christopher V DeSimone, Yehu Sapir, Jennifer Dugan, Virend K Somers, Michael J Ackerman, Samuel J Asirvatham, Christopher G Scott, Kevin E Bennet, Dorothy J Ladewig, Dan Sadot, Amir B Geva, Paul A Friedman
OBJECTIVE: We have previously used a 12-lead, signal-processed ECG to calculate blood potassium levels. We now assess the feasibility of doing so with a smartphone-enabled single lead, to permit remote monitoring. PATIENTS AND METHODS: Twenty-one hemodialysis patients held a smartphone equipped with inexpensive FDA-approved electrodes for three 2min intervals during hemodialysis. Individualized potassium estimation models were generated for each patient. ECG-calculated potassium values were compared to blood potassium results at subsequent visits to evaluate the accuracy of the potassium estimation models...
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28615004/understanding-heart-failure-explaining-telehealth-a-hermeneutic-systematic-review
#6
Trisha Greenhalgh, Christine A'Court, Sara Shaw
BACKGROUND: Enthusiasts for telehealth extol its potential for supporting heart failure management. But randomised trials have been slow to recruit and produced conflicting findings; real-world roll-out has been slow. We sought to inform policy by making sense of a complex literature on heart failure and its remote management. METHODS: Through database searching and citation tracking, we identified 7 systematic reviews of systematic reviews, 32 systematic reviews (including 17 meta-analyses and 8 qualitative reviews); six mega-trials and over 60 additional relevant empirical studies and commentaries...
June 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28614141/role-of-hemorrhagic-shock-in-experimental-polytrauma
#7
Stephanie Denk, Sebastian Weckbach, Philipp Eisele, Christian K Braun, Rebecca Wiegner, Julia J Ohmann, Lisa Wrba, Felix M Hoenes, Philipp Kellermann, Peter Radermacher, Ulrich Wachter, Sebastian Hafner, Oscar McCook, Anke Schultze, Annette Palmer, Sonja Braumüller, Florian Gebhard, Markus Huber-Lang
Hemorrhagic shock (HS) after tissue trauma increases the complication and mortality rate of polytrauma (PT) patients. Although several murine trauma models have been introduced, there is a lack of knowledge about the exact impact of an additional HS. We hypothesized that HS significantly contributes to organ injury, which can be reliably monitored by detection of specific organ damage markers.Therefore we established a novel clinically relevant PT plus HS model in C57BL/6 mice which were randomly assigned to control, HS, PT or PT+HS procedure (n = 8 per group)...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28613188/automated-spirometry-quality-assurance-supervised-learning-from-multiple-experts
#8
Filip Velickovski, Robert Marti, Luigi Ceccaroni, Felip Burgos, Concepcion Gistau, Xavier Alsina-Restoy, Josep Roca
Forced spirometry testing is gradually becoming available across different healthcare tiers including primary care. It has been demonstrated in earlier work that commercially available spirometers are not fully able to assure the quality of individual spirometry manoeuvres. Thus a need to expand the availability of high quality spirometry assessment beyond specialist pulmonary centres has arisen. In this work we propose a method to select and optimise a classifier using supervised learning techniques by learning from previously classified forced spirometry tests from a group of experts...
June 8, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28612995/the-patient-perspective-on-remote-monitoring-of-patients-with-an-implantable-cardioverter-defibrillator-narrative-review-and-future-directions
#9
REVIEW
I Timmermans, M Meine, E Zitron, J Widdershoven, G Kimman, S Prevot, T Rauwolf, F Anselme, I Szendey, J Romero Roldán, P Mabo, B Schaer, J Denollet, H Versteeg
BACKGROUND: Studies have shown that remote monitoring (RPM) of implantable cardioverter defibrillators (ICDs) is at least comparable to in-clinic follow-up with regard to clinical outcomes and might be cost-effective, yet RPM is not standard clinical practice within Europe. Better insight into the patient perspective on RPM may aid in its acceptance, implementation and reimbursement. This narrative review 1) summarizes existing evidence on the impact of RPM on patient reported outcomes and 2) discusses future directions in examining the patient perspective...
June 14, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28612635/wearable-sensors-can-they-benefit-patients-with-chronic-kidney-disease
#10
Fokko Pieter Wieringa, Natascha Broers, J P Kooman, Frank M van der Sande, Chris van Hoof
Introduction This article ponders upon wearable medical measurement devices in relation to Chronic Kidney Disease (CKD) and its' associated comorbidities - and whether these might benefit CKD-patients. We aimed to map the intersection(s) of nephrology and wearable sensor technology to help technologists understand medical aspects, and clinicians to understand technological possibilities that are available (or soon will become so). Areas covered A structured literature search on main comorbidities and complications CKD patients suffer from, was used to steer mini-reviews on wearable sensor technologies clustered around 3 themes being: Cardiovascular-related, diabetes-related and physical fitness/frailty...
June 14, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28611672/telemedicine-for-the-management-of-glycemic-control-and-clinical-outcomes-of-type-1-diabetes-mellitus-a-systematic-review-and-meta-analysis-of-randomized-controlled-studies
#11
REVIEW
Shaun W H Lee, Leanne Ooi, Yin K Lai
Importance: Telemedicine has been shown to be an efficient and effective means of providing care to patients with chronic disease especially in remote and undeserved regions, by improving access to care and reduce healthcare cost. However, the evidence surrounding its applicability in type 1 diabetes remains scarce and conflicting. Objective: To synthesize evidence and quantify the effectiveness of telemedicine interventions for the management of glycemic and clinical outcomes in type 1 diabetes patients, relative to comparator conditions...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28608613/remote-control-improves-quality-of-life-in-elderly-pacemaker-patients-versus-standard-ambulatory-based-follow-up
#12
Rosanna Irene Comoretto, Domenico Facchin, Marco Ghidina, Alessandro Proclemer, Dario Gregori
BACKGROUND: Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation. No studies have investigated the HRQoL trend for elderly patients with a remote device monitoring follow-up system. METHODS: Using EuroQol-5D Questionnaire and the PM-specific Assessment of Quality of Life and Related Events Questionnaire, HRQoL was measured at baseline and then repeatedly during the 6 months following PM implantation in a cohort of 42 consecutive patients...
June 13, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28607383/isolation-detection-and-quantification-of-cancer-biomarkers-in-hpv-associated-malignancies
#13
Hakan Inan, Shuqi Wang, Fatih Inci, Murat Baday, Richard Zangar, Sailaja Kesiraju, Karen S Anderson, Brian T Cunningham, Utkan Demirci
Human Papillomavirus (HPV) infection has been recognized as the main etiologic factor in the development of various cancers including penile, vulva, oropharyngeal and cervical cancers. In the development of cancer, persistent HPV infections induce E6 and E7 oncoproteins, which promote cell proliferation and carcinogenesis resulting elevated levels of host antibodies (e.g., anti-HPV16 E7 antibody). Currently, these cancers are clinically diagnosed using invasive biopsy-based tests, which are performed only in centralized labs by experienced clinical staff using time-consuming and expensive tools and technologies...
June 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28604628/privacy-preserving-electrocardiogram-monitoring-for-intelligent-arrhythmia-detection
#14
Junggab Son, Juyoung Park, Heekuck Oh, Md Zakirul Alam Bhuiyan, Junbeom Hur, Kyungtae Kang
Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components...
June 12, 2017: Sensors
https://www.readbyqxmd.com/read/28602223/is-enhanced-recovery-enough-for-reducing-30-d-readmissions-after-surgery
#15
Anne C Fabrizio, Michael C Grant, Zishan Siddiqui, Yewande Alimi, Susan L Gearhart, Christopher Wu, Jonathan E Efron, Elizabeth C Wick
BACKGROUND: Few enhanced recovery pathways (ERPs) include processes related to the hospital to home transfer. Little has been reported regarding readmissions in enhanced recovery programs. This study evaluates readmissions and identifies areas to optimize ERPs to prevent readmissions. METHODS: We conducted an observational, retrospective study at a single tertiary care center. Patients in an ERP for colorectal surgery were compared with a similar cohort who underwent surgery before protocol implementation...
April 22, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600234/rescsrf-algorithm-to-automatically-extract-cheyne-stokes-respiration-features-from-respiratory-signals
#16
Faizan Javed, Henrik Fox
OBJECTIVE: Cheyne-Stokes respiration (CSR) related features are significantly associated with cardiac dysfunction. Scoring of these features is labor-intensive and time-consuming. To automate the scoring process, an algorithm (ResCSRF) has been developed to extract these features from nocturnal measurement of respiratory signals. METHODS: ResCSRF takes 4 signals (nasal flow, thorax, abdomen and finger oxygen saturation) as input. It first detects CSR cycles and then calculates the respiratory features [cyclelength (CL), lung-to-periphery circulation time (LPCT) and time to peak flow (TTPF)]...
June 5, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28595994/-news-techniques-of-pacing-in-congenital-heart-diseases
#17
Mathieu Le Bloa, Jean-Benoît Thambo
The number of children and adult with congenital heart disease requiring implantation of cardiac pacemaker or cardioverter defibrillator is constantly increasing. The lead between stimulation/defibrillation site and the generator constitutes the main weakpoint of those devices despite the numerous recent technological advances: use of bipolar probes, corticoid elution electrodes, insulation improvement, magnetic resonance imaging (MRI) compatibility. Risk of device failure remains high in this population. Long term adverse events with endovascular devices remain high...
June 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28594371/on-line-service-composition-in-the-integrated-clinical-environment-for-ehealth-and-medical-systems
#18
Marisol García-Valls, Imad Eddine Touahria
Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors. ICE is simply a high level architecture that defines the functional blocks that should be part of a medical system to support interoperability...
June 8, 2017: Sensors
https://www.readbyqxmd.com/read/28593341/activation-of-remote-monitoring-for-cardiac-implantable-electronic-devices-small-dog-for-tall-weeds
#19
Giuseppe D'Ancona, Erdal Safak, Jochen Senges, Matthias Hochadel, Van Luyen Nguyen, Christian Perings, Werner Jung, Stefan Spitzer, Lars Eckardt, Johannes Brachmann, Karlheinz Seidl, Hans Ulrich Hink, Hüseyin Ince, Jasmin Ortak
BACKGROUND: Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has been popularized as a precious patients' management tool. We have investigated RM within the premises of a multicenter, prospective, real-world registry, i.e., the German Device II. METHODS: We have focused on: (1) CIEDs with RM capabilities implantation rate and (2) actual rate of RM features activation. RESULTS: A cohort of 1223 CIEDs patients were treated from 04/11 to 02/14...
June 7, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28592924/suppression-of-endothelial-cell-migration-by-tumor-associated-macrophage-derived-exosomes-is-reversed-by-epithelial-ovarian-cancer-exosomal-lncrna
#20
Quanfeng Wu, Xiaoli Wu, Xiang Ying, Qinyi Zhu, Xinjing Wang, Lu Jiang, Xin Chen, Yueqian Wu, Xipeng Wang
OBJECTIVE: To study the mechanism by which epithelial ovarian cancer (EOC)-derived exosomes restore the migration of endothelial cells that is suppressed by TAM-derived exosomes. METHODS: Exosomes were isolated from TAMs in the ascites of patients with EOC. The effect of exosomes on the expression of endothelial cell miRNA was monitored by PCR. The miRNA mimics were transfected to explore their effects. Microarray data and literature searches were used to predict target genes and the impact of target gene pathways, and small interfering RNA was used to target these genes...
2017: Cancer Cell International
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