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Challenges to establish new medical technologies, that are not yet contractually stipulated with the insurers, into the daily medical routine
Get PDFAdvances in medical care are to a large extent brought forward by new medical technologies. Their implementation into daily medical routine requires a careful handling to be of rational use for individual patients and to avoid harm as well. For this responsible task critical key questions are listed for the deciding medical doctor treating an individual patient, for a conclusive scientific evaluation and as a decision support for insurers and policy makers to assess the economic potentials and regulatory challenges of new medical technologies and innovations
Epidemiological and clinical characteristics of human brucellosis in Razavi Khorasan proivince and important risk factors in the years 2008 to 2013
Get PDFBackground & Purpose: Brucellosis is a transmissible disease between humans and animals that is transmitted through infected animals and their products. Razavi Khorasan which is classified as a high incidence province, considered as one of the notable areas for controlling the disease.
Materials &Methods: Data on 5743 cases in Razavi Khorasan (Mashhad Medical University Coverage) over 5 years were analyzed. A GIS map is designed to show and compare incidence rate among different regions using ArcGIS software and different correlations between patients specifications are analyzed.
Results: The mean incidence of disease in the province is 26 per hundred thousand people which is highly correlated to animal population of every area. In the first 3 years of study the disease incidence was ascending and in last 2 years it was descending and in May till August the prevalence was more than other months.85% of patients were rural and 15% were urban. 56.9% were male and 43.1% female. Household and farmer-rancher were the most common jobs. Average age of patients was 33.4 ±18.1 year. 77.2% had consumption of unpasteurized dairy products which milk (91.4%) and cheese (21.4%) had the highest consumption. The most common symptoms were fever (79%) and anorexia (47.5%). A significant relationship between location and both livestock vaccination history and also family history, was found.
Conclusion: because of higher incidence rate of the disease in Daregaz, Takhtjolge and Rashtkhar, and young people aged 10 to 30 years and villagers, It’s need to control the disease in these groups
Polymorphism rs3087243 is associated with the occurrence of ankylosing spondylitis in the West Algerian population
Get PDFBackground: Numerous studies have shown that polymorphism rs231775 of the CTLA4 gene is strongly implicated in the development of ankylosing spondylitis (AS). Other polymorphisms of this gene are candidates that may have an additional effect in susceptibility to AS. For the first time, we searched for the association of rs3087243 polymorphism located in the 3\u27UTR region of the CTLA4 gene with the development of SA in the Algerian population.
Methods: The study involved 200 subjects (80 AS patients recruited at the rheumatology service and 120 healthy individuals unrelated). Genotyping was performed by real-time PCR (Taqman®). Analysis of the results was carried out by IBM.SPSS.Statictis® software.
Results: The distribution of allele frequencies showed a significant association between the GG genotype of the polymorphism rs3087243 and AS risk (OR= 1.77 [0.98-3.21], p=0.004).
Conclusion: Our data would suggest that the 3\u27UTR region of the CTLA4 gene could have an impact on the development of SA in the West Algerian population. These results need to be confirmed on a larger sample
An Efficient Algorithm for Multimodal Medical Image Fusion based On Feature Selection and PCA Using DTCWT.
Get PDFBackground: In the two past decades, medical image fusion has become an essential part of modern medicine due to the availability of numerous imaging modalities (MRI, CT, SPECT. etc). This paper presents a new medical image fusion algorithm based on DTCWT and uses different fusion rules in order to obtain a new image which contains more information than any of the input images.
Methods: In order to improve the visual quality of the fused image, we propose a new image fusion algorithm based on Dual Tree Complex Wavelet Transform (DTCWT). Using different fusion rules in a single algorithm leads to a perfect reconstruction of the output (fused image).This combination will create a new method which exploits the advantages of each method separately. DTCWT present good directionality since it considers the edge information in six directions and provides approximate shift invariant. The goal of Principal Component Analysis (PCA) is to extract the most significant features (wavelet coefficients in our case) in order to improve the spatial resolution. The proposed algorithm fuses the detailed wavelet coefficients of input images using features selection rule.
Results: We have conducted several experiments over different sets of multimodal medical images such as CT/MRI, MRA/T1-MRI; however, only results of two sets have been presented (due to pages-limit). The proposed fusion algorithm is compared to recent fusion methods presented in the literature (eight methods) in terms of visual quality and quantitatively using well known fusion performance metrics (five metrics). Results showed that the proposed algorithm outperforms the existing ones in terms of visual and quantitative evaluations.
Conclusion: This paper focuses on image fusion of medical images obtained from different modalities. We have proposed a novel algorithm based on DTCWT in order to merge multimodal medical images. Experiments have been performed over two different sets of multimodal medical images. The results show that the proposed method significantly outperforms other techniques reported in the literature
THE USAGE OF MEDICAL INFORMATICS IN CRITICAL CARE MEDICINE
Get PDFIntroduction: The intensive care unit can be defined as a complex system that composed of clinical informations, tasks and knowledge. It is also one of the most stressful and most vital parts of healthcare centers which involve a huge amount of information and clinical data daily. These informations should be analyzed and managed in the best way as soon as possible to restore patients to normal by health professionals. Accurate and timely diagnosis, the best treatment and to avoid any possible error in this section can be equivalent to achieve the best possible result and reducing the length of hospitalization and mortality. As a result, due to the complex nature of the critical care and the mass of clinical data; using a combination of medical knowledge with the latest technologies and use of medical informatics capabilities can be the best way to reduce the workload of the sector and improve the quality of patient care.
Methods: A systematic search was conducted on the PubMed/MEDLINE, web of science, BMJ, ScienceDirect, and Scopus database for finding studies that have related to critical care and usage of informatics or medical informatics. The collected data and results are summarized by researchers and the results analyzed based on similarities and differences.
Results: With increased development of medical informatics and electronic systems has led to substantial progress in the field of critical care since 1980 till now around the world. Several articles, research projects has published. From 1981 to 2016 almost 600 scientific papers were found which included reports, posters and thesis written in context of critical care medical informatics. More than 65 percent of these studies is about designing CDSS in this field. Today, many of these systems are used in medical centers around the world and lead to improving the quality of patient care and reduce medical errors in intensive care units. Among these 600 papers, 230 articles related to our issue in fields of the design of electronic records, clinical information systems, decision support systems, data mining, telemedicine, smart analysis of clinical information and knowledge extraction techniques were selected as the main source of this study.
Conclusion: According to results of our study, it seems that critical care is potentially a valuable resource for medical informatics researches. The applied of medical informatics in the different fields of the diagnosis, interpretation, and treatment in different countries have improved the quality of care for patients in critical care field. We can mention some common fields which used such as infection control and early detection in intensive care units, clinical information systems, and CPOE and decision support systems such as APACHE system for grading the severity of illness of patients who hospitalized and even telemedicine. Since this area of research has not been a field of interest in Iran yet, it seems that this study with the aim of review the application of medical informatics in different countries could lead to practical researches in this field
DESIGNING THE MINIMUM DATA SET OF PSYCHIATRIC EMERGENCY RECORD
Get PDFIntroduction:
Psychiatric emergencies are acute mental health disturbances, behavior and social relationship that require immediate intervention. The major role of psychiatric emergency services is to provide mental health care services for patients with acute mental health problems. Design emergency psychiatry core dataset has improved the coordination and integration of services and improved the outcomes for the patient with severe and persistent mental illness with complex needs. So the aim of this study was to design data elements (DEs) in emergency psychiatry for Iran.
Methods:
This is an applied study. Emergency psychiatry (DEs) collected via literature review and then psychologist and psychiatrist (16 experts) assign the score from 0 to 5 to them according to the value of each data element. (DEs) selected as core Emergency psychiatry (DEs) that were achieved 4 or 5 scores from 75% specialist.
Results:
According to the literature review, 110 (DEs) included studying. 13 experts (8 psychologists, 8 Clinical Psychologist) evaluated psychiatric emergency (DEs) set. The average work experience of psychiatrists and psychologists was 16 years and their work experience ranged from 2 to 25 years (table 1). according to the experts opinion, 54 (DEs) with at least 75% of the agreement were identified as the psychiatric emergency (DEs). Emergency psychiatric (DEs) and average agreement of each of them were: demographic characteristics (6 DEs with an agreement average of 82.5%), history of mental illness (9 DEs with an agreement average of 79%), family history of psychology (3 DEs with an average agreement of 77.08%), medical history (1 DEs with an average agreement of 81.25 %) Assessment of mental status ( 20 DEs with an average agreement of 82%), assessment of the self harm risk or harm risk for others ( 13 DEs with an average agreement of 93.6%) and diagnosis and treatment (3 DEs with an average agreement of 81.25%).
Conclusion:
Given the importance of psychiatric disorder and lack of the national system for gathering psychiatric information, perform the same study abut psychiatric data element is very important. The results of this study can be used for design psychiatric emergency forms and gather accurate and complete patient information
Critical Literature Review: Preparation Strategies
Get PDFThe imperative needs for, and characteristics of an effective critical literature review, provide the foreground baseline deliberation. A visual model depicting synthesized major modular components of a research project delineate impact points of literature review inputs. The three major modules represent preparation, data capture, and data rendering-analysis-interpretation phases of research. Within each module, the literature review elements to be incorporated are elaborated. Steps and optimal articulation-action strategies are highlighted and embedded with examples from literature and theses. Development of competency and efficacy in critiquing and evaluating, which comprised mandatory skills to acquire, is especially focussed
Attitude and readiness of Dentistry students in Kerman University of Medical Sciences concerning Tele-dentistry in 2017
Get PDFIntroduction: Tele-dentistry is the use of information and telecommunications technology for dental care, counseling, education and public awareness in the same way as remote medical. Tele-dentistry is a relatively new field that can change the dental care system. However, many dentists are unaware of the goals, benefits, and how to participate. Therefore, this study was conducted to determine the knowledge and attitude of dental students regarding telemedicine.
Methods:The present study is descriptive-analytic. The study population consisted of all dental students in Kerman in year 2017 and sample of 230 students selected by proportional sampling. For data collection, a complete English translation of an English-language article in the Journal of Clinical and Diagnostic Research, whose validity was confirmed by three of the leading medical informatics specialists in English, was then used to analyze the data using the software SPSS 19.
Results: The findings of this study showed that there is no significant difference between the students\u27 age, sex and term of education with their knowledge of tele-dentistry (P>0.05). Knowledge and attitude of 72% of students in tele-dentistry is very low. 40% of them said tele-dentistry would be very beneficial and more than half of them would be willing to do tele-dentistry in the future. 81% of them agreed that tele-dentistry could be a good tool for health education and oral health, and effective in educating the health of a large number of people. 75% of them felt that distance dental care saves time, and 81% of students believed that tele-dentistry was not financially feasible.
Conclusion: The results of this study showed that many respondents lacked adequate knowledge and knowledge about tele-dentistry. Hence, there is a huge need for awareness among dentists to further the future of dentistry in the future. Therefore, it is suggested that the related institutions take more serious measures for awareness and education about tele-dentistry for students
The effect of socioeconomic status on ambulance requests
Get PDFIntroduction:
Emergency medical events are not randomly distributed over a certain area. Many hidden patterns may influence this distribution due to several socioeconomic, demographic, and geospatial factors. Identifying these patterns will help health policy makers have a better planning for emergency medical services (EMS) in finding high-risk places, and people at high risk.
Methods:
Mashhad city EMS calls records have been analyzed retrospectively. The privacy of the data was considered by eliminating the identification information such as the name or phone number of the patients. To recognize the location of the requests all the recorded addresses were mapped into a single number representing the municipality region of the address. To express the relationship between the predictors, correlation coefficient has been employed.
Results:
154528 calls in a citywide registry from March 21, 2013, to March 20, 2014, were investigated. The average of age was 42.43 years (S.D = 21.7) with 50.5% male, 40.7% female and 8.8% of the sex were not registered. 64% of the calls were medical related and the remaining 36% were trauma-related requests. Aside from traffic accident that was the top most in all regions, other top five reasons for ambulance request including weakness, seizure, unconsciousness, nervous stress, and dyspnea were recognized. Although the regions with lower socioeconomic status are more vulnerable, they request ambulances less frequently than the regions with higher socioeconomic status.
Conclusion:
There is a relationship between the socioeconomic status of people and their calls to EMS. The results of this study can help policymakers in finding people in potentially high-risk locations and provide facilities to reduce mortality and morbidity
Design of CAD System of Solitary Pulmonary Nodule with Harmony Classification and Fuzzy System
Get PDFIntroduction: Lung cancer is the most wide spread from of cancer, with the highest mortality rate worldwide. In this study, a computer-aided detection (CAD) system was developed for lung nodule detection, segmentation and recognition using CT images. So, we use a highly accurate supervised that uses lung images with the aim of assisting physicians in early detection of lung cancer.
Methods: First, we segmented the lung area by masking techniques to isolated nodules and determined region of interest. Then, 24 features were extracted from images that included morphological, statistical and histogram. Important features were derived from the images for their posterior analysis with the aid of a harmony search algorithm and fuzzy systems.
Results: In order to evaluate the performance of the proposed method, we used the LIDC database. the number of images included a database of 97 images whom 47 were diagnosed with lung cancer. Results of the base method show a sensitivity of 93%.
Conclusion: The harmony search algorithm is optimized using fuzzy system for classification. The CAD system provides 93.1% accuracy