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https://www.readbyqxmd.com/read/28229894/mobile-stroke-units-for-prehospital-thrombolysis-triage-and-beyond-benefits-and-challenges
#1
REVIEW
Klaus Fassbender, James C Grotta, Silke Walter, Iris Q Grunwald, Andreas Ragoschke-Schumm, Jeffrey L Saver
In acute stroke management, time is brain. Bringing swift treatment to the patient, instead of the conventional approach of awaiting the patient's arrival at the hospital for treatment, is a potential strategy to improve clinical outcomes after stroke. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and appropriate medication. Studies of prehospital stroke treatment consistently report a reduction in delays before thrombolysis and cause-based triage in regard to the appropriate target hospital (eg, primary vs comprehensive stroke centre)...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28228369/feasibility-of-implementing-a-patient-centered-postoperative-wound-monitoring-program-using-smartphone-images-a-pilot-protocol
#2
Sara Fernandes-Taylor, Rebecca L Gunter, Kyla M Bennett, Lola Awoyinka, Shahrose Rahman, Caprice C Greenberg, K Craig Kent
BACKGROUND: Surgical site infections (SSI) represent a significant public health problem as the most common nosocomial infection and a leading cause of unplanned hospital readmissions among surgical patients. Many develop following hospital discharge and often go unrecognized by patients. Telemedicine offers the opportunity to leverage the mobile technology to remotely monitor wound recovery in the transitional period between hospital discharge and routine clinic follow-up. However, many existing telemedicine platforms are episodic, replacing routine follow-up, rather than equipped for continued monitoring; they include only low-risk patient populations and those who already have access to and comfort with the necessary technology; and transmit no visual information...
February 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28226619/application-of-semi-supervised-deep-learning-to-lung-sound-analysis
#3
Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Daniel Chamberlain, Rahul Kodgule, Daniela Ganelin, Vivek Miglani, Richard Ribon Fletcher, Vivek Miglani, Daniel Chamberlain, Richard Ribon Fletcher, Rahul Kodgule, Daniela Ganelin
The analysis of lung sounds, collected through auscultation, is a fundamental component of pulmonary disease diagnostics for primary care and general patient monitoring for telemedicine. Despite advances in computation and algorithms, the goal of automated lung sound identification and classification has remained elusive. Over the past 40 years, published work in this field has demonstrated only limited success in identifying lung sounds, with most published studies using only a small numbers of patients (typically N<;20) and usually limited to a single type of lung sound...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224944/managing-ckd-by-telemedicine-the-zuni-telenephrology-clinic
#4
REVIEW
Andrew S Narva, Gayle Romancito, Thomas Faber, Michael E Steele, Kenneth M Kempner
Telemedicine has significant potential to extend nephrology consultation to rural and isolated communities. We describe a telenephrology clinic that has delivered ongoing consultative care from a nephrologist based at the National Institutes of Health in Bethesda, MD, to the Zuni Comprehensive Health Center in western New Mexico. Over the past 9 years, the clinic has conducted 1870 patient visits managing patients using a collaborative approach engaging a nurse case manager, nephrologist, primary clinicians, pharmacists, and community health nurses...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28183341/assessing-the-feasibility-of-ehealth-and-mhealth-a-systematic-review-and-analysis-of-initiatives-implemented-in-kenya
#5
REVIEW
Martin Njoroge, Dejan Zurovac, Esther A A Ogara, Jane Chuma, Doris Kirigia
BACKGROUND: The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya...
February 10, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28169119/reperfusion-therapy-of-myocardial-infarction-in-mexico-a-challenge-for-modern-cardiology
#6
Carlos Martínez-Sánchez, Alexandra Arias-Mendoza, Héctor González-Pacheco, Diego Araiza-Garaygordobil, Luis Alfonso Marroquín-Donday, Jorge Padilla-Ibarra, Carlos Sierra-Fernández, Alfredo Altamirano-Castillo, Amada Álvarez-Sangabriel, Francisco Javier Azar-Manzur, José Luis Briseño-de la Cruz, Salvador Mendoza-García, Yigal Piña-Reyna, Marco Antonio Martínez-Ríos
Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises...
February 3, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28166828/a-psychological-intervention-to-promote-acceptance-and-adherence-to-non-invasive-ventilation-in-people-with-chronic-obstructive-pulmonary-disease-study-protocol-of-a-randomised-controlled-trial
#7
Eleonora Volpato, Paolo Banfi, Francesco Pagnini
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) sometimes experience anxiety, depression and comorbid cognitive deficits. Rather than being merely a consequence of symptom-related physical impairments these additional problems may be part of the clinical course of the condition. The relationship between the physical and psychological aspects of the condition is illustrated by the patterns of use of non-invasive ventilation (NIV); NIV is often rejected or used inappropriately, resulting in clinical deterioration and an increase in health care costs...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28138988/telemedical-care-and-monitoring-for-patients-with-chronic-heart-failure-has-a-positive-effect-on-survival
#8
Robert Herold, Neeltje van den Berg, Marcus Dörr, Wolfgang Hoffmann
BACKGROUND: Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. METHODS: We evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis...
January 31, 2017: Health Services Research
https://www.readbyqxmd.com/read/28138788/young-patients-with-type-1-diabetes-poorly-controlled-and-poorly-compliant-with-self-monitoring-of-blood-glucose-can-technology-help-results-of-the-i-newtrend-randomized-clinical-trial
#9
Paolo Di Bartolo, Antonio Nicolucci, Valentino Cherubini, Diario Iafusco, Marco Scardapane, Maria Chiara Rossi
AIMS: To compare iBGStar™ + DMApp (experimental meter + telemedicine system) (iBGStar) with a traditional glucose meter (Control) in type 1 diabetes adolescents/young adults. METHODS: i-NewTrend was a multicenter, open-label, randomized trial involving subjects aged 14-24 years, on basal-bolus insulin, HbA1c ≥ 8.0%, and poorly compliant with SMBG (i.e., <30% of the recommended frequency). Primary end points were change in HbA1c and achievement of compliance with SMBG (≥30% of the recommended frequency) after 6 months...
January 30, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28131346/improving-access-to-stroke-care-in-the-rural-setting-the-journey-to-acute-stroke-ready-designation
#10
Andrea Slivinski, Robin Jones, Hollis Whitehead, Vallire Hooper
: Stroke is the fifth highest cause of death and the leading cause of long-term disability in the United States. North Carolina has one of the highest death rates from stroke in the nation. Access to acute stroke care in rural western North Carolina is limited, with only one primary stroke center within an 18-county region. Angel Medical Center, located in rural western North Carolina, sought to pursue The Joint Commission's disease-specific certification as an Acute Stroke Ready Hospital in an effort to improve stroke care and outcomes across the region...
January 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28126019/telemedical-support-for-prehospital-emergency-medical-service-tems-trial-study-protocol-for-a-randomized-controlled-trial
#11
Ana Stevanovic, Stefan Kurt Beckers, Michael Czaplik, Sebastian Bergrath, Mark Coburn, Jörg Christian Brokmann, Ralf-Dieter Hilgers, Rolf Rossaint
BACKGROUND: Increasing numbers of emergency calls, shortages of Emergency Medical Service (EMS), physicians, prolonged emergency response times and regionally different quality of treatment by EMS physicians require improvement of this system. Telemedical solutions have been shown to be beneficial in different emergency projects, focused on specific disease patterns. Our previous pilot studies have shown that the implementation of a holistic prehospital EMS teleconsultation system, between paramedics and experienced tele-EMS physicians, is safe and feasible in different emergency situations...
January 26, 2017: Trials
https://www.readbyqxmd.com/read/28118550/smartphone-enabled-otoscopy-in-neurotology-otology
#12
Omid Moshtaghi, Ronald Sahyouni, Yarah M Haidar, Melissa Huang, Afsheen Moshtaghi, Yaser Ghavami, Harrison W Lin, Hamid R Djalilian
Objective A smartphone-enabled otoscope (SEO) can capture tympanic membrane (TM) images. We sought to compare a SEO to microscopic otoscopy in the detection and evaluation of TM pathology in an otology/neurotology practice. Study Design Prospective single-site study in adults presenting over a 3-month period. Setting Neurotology clinic within a tertiary care academic medical center. Subjects and Methods Following consent, 57 patients underwent a medical and microscopic ear examination. Afterward, clinicians photographed bilateral TMs using a SEO...
January 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28100957/conditions-for-success-in-introducing-telemedicine-in-diabetes-foot-care-a-qualitative-inquiry
#13
Beate-Christin Hope Kolltveit, Eva Gjengedal, Marit Graue, Marjolein M Iversen, Sally Thorne, Marit Kirkevold
BACKGROUND: The uptake of various telehealth technologies to deliver health care services at a distance is expanding; however more knowledge is needed to help understand vital components for success in using telehealth in different work settings. This study was part of a larger trial designed to investigate the effect of an interactive telemedicine platform. The platform consisted of a web based ulcer record linked to a mobile phone to provide care for people with diabetic foot ulcers in outpatient clinics in specialist hospital care in collaboration with primary health care...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28056832/telemedicine-and-primary-care-obesity-management-in-rural-areas-innovative-approach-for-older-adults
#14
John A Batsis, Sarah N Pletcher, James E Stahl
BACKGROUND: The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity...
January 5, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28025929/hemophilia-management-via-data-collection-and-reporting-initial-findings-from-the-comprehensive-care-sustainability-collaborative
#15
Michael D Tarantino, Vanita K Pindolia
BACKGROUND: Despite being a rare disorder, hemophilia represents a significant driver of health care resource utilization and requires expert hematologic and multidisciplinary services to achieve optimal outcomes. Since their inception nearly 40 years ago, hemophilia treatment centers (HTCs) have served as centers of excellence in providing the intensive care and ancillary services necessary for this unique patient base; however, the full capabilities of these centers may be underused in the current framework of managed care, largely because of a lack of communication and information shared between payers and HTC stakeholders...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28002690/diabsat-telemedicine-itinerant-screening-of-chronic-complications-of-diabetes-using-a-satellite
#16
Marie-Christine Turnin, Solène Schirr-Bonnans, Marie-Christine Chauchard, Patrice Deglise, Catherine Journot, Yann Lapeyre, Antonio Güell, Benoit Lepage, Helene Hanaire, Jacques Martini
BACKGROUND: Health authorities recommend regular screening for the chronic complications of diabetes. The ENTRED (*) survey results show that insufficient screening is undertaken. The DIABSAT (†) program aims to improve care for diabetes patients in rural areas of the Midi-Pyrénées region, telemonitoring complications of diabetes through an itinerant screening service. METHODS: A vehicle was equipped with a satellite dish and medical equipment for screening ophthalmological, renal, vascular, and neuropathic damage and assessing the level of risk of diabetic foot ulceration...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28002689/design-and-implementation-of-a-telepediatric-primary-level-and-low-cost-system-to-reduce-unnecessary-patient-transfers
#17
Christian Cifuentes, Eduardo Romero, Javier Godoy
BACKGROUND: Most inhabitants in Latin America are concentrated in large urban foci with different access to facilities. Although the main hospitals offer specialized services, economically vulnerable populations cannot easily afford these services, the pediatric population being most affected. This article presents the design and implementation of a low cost telepediatric system, applied to primary care hospitals through a study in Bogotá, Colombia, mainly aimed to reduce the number of unnecessary transfers commonly sent to specialized medical services...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27998682/telemedicine-specialty-support-promotes-hepatitis-c-treatment-by-primary-care-providers-in-the-department-of-veterans-affairs
#18
Lauren A Beste, Thomas J Glorioso, P Michael Ho, David H Au, Susan R Kirsh, Jeffrey Todd-Stenberg, Michael F Chang, Jason A Dominitz, Anna E Barón, David Ross
BACKGROUND & AIMS: The Department of Veterans Affairs (VA) is the largest US provider of hepatitis c treatment. Although antiviral regimens are becoming simpler, hepatitis c antivirals are not typically prescribed by primary care providers (PCPs). The VA-Extension for Community Health Outcomes (VA-ECHO) program was launched to promote primary care-based hepatitis C treatment using videoconferencing-based specialist support. We aimed to assess whether PCP participation in VA-ECHO was associated with hepatitis C treatment and sustained virologic response...
December 17, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27998380/the-past-is-prologue-the-future-of-sleep-medicine
#19
Nathaniel F Watson, Ilene M Rosen, Ronald D Chervin
The field of sleep medicine has gone through tremendous growth and development over a short period of time, culminating in recognition of the field as an independent medical subspecialty by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). However, the fellowship training requirement that is now mandatory for sleep medicine board certification eligibility has had the unintended consequence of restricting the influx of young physicians to the field...
January 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27932050/icu-telemedicine-program-financial-outcomes
#20
Craig M Lilly, Christine Motzkus, Teresa Rincon, Shawn E Cody, Karen Landry, Richard S Irwin
BACKGROUND: ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. METHODS: Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group)...
February 2017: Chest
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