29 research outputs found
Supplemental material for Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
No full textSupplemental material for Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure by Ines Frederix, Lien Vanderlinden, Anne-Sophie Verboven, Maria Welten, Donna Wouters, Gilles De Keulenaer, Bavo Ector, Ivan Elegeert, Pierre Troisfontaines, Caroline Weytjens, Wilfried Mullens and Paul Dendale in Journal of Telemedicine and Telecare</p
Effect of a telemonitoring‐facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA‐HF 1 (TElemonitoring in the MAnagement of Heart Failure) study
No full textAims Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate.
Methods and results One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM.
Conclusion Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial
Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
No full textAbstract: Aims The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t(0)); 142 CHF patients (65% male; age: 76 +/- 10 years; EF: 36 +/- 15%) were alive and entered the follow-up study (time point: t(1)) with a final evaluation at 79 months (time point: t(2)). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t(1) -t(2)). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group (p = 0.04). Healthcare costs did not differ significantly between the TM (euro 9140 +/- 10580) and UC group (euro 12495 +/- 22433) (p = 0.87). Discussion An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: )
Acute myocardial infarction due to spontaneous postpartum multi-vessel coronary artery dissection
No full textAbstractSpontaneous coronary artery dissection is a rare cause of myocardial infarction in young, otherwise healthy people. We present a case report of a 37-year-old woman, without cardiovascular risk factors, who survived a major acute myocardial infarction due to multi-vessel spontaneous coronary artery dissection which was complicated by cardiogenic shock in the third week postpartum. She fully recovered with medical therapy in combination with angioplasty.<Learning objective: Acute myocardial infarction (AMI) during pregnancy and postpartum is a rare but often catastrophic event and spontaneous coronary artery dissection is the most frequent cause of AMI in this population. Because of the high mortality rate, it is important to recognize this entity in the early stage of presentation. Coronary angiography remains the golden standard and should be performed without hesitation in unstable patients.
Fig6_FigS6_LDA_PCA_Data
No full textData underlying Figures 6 and S6 of the manuscript "Time-of-day effects of drugs revealed by high-throughput deep phenotyping." by C. Ector et al. with the corresponding author A.E.Granada.Methodology described in the Methods section of above mentioned manuscript.</p
Fig5_FigS5_Determinants_Data
No full textData underlying Figures 5 and S5 of the manuscript "Time-of-day effects of drugs revealed by high-throughput deep phenotyping." by C. Ector et al. with the corresponding author A.E.Granada.Methodology described in the Methods section of above mentioned manuscript.</p
Fig2_FigS1_Circadian_Data
No full textData underlying Figures 2 and S1 of the manuscript "Time-of-day effects of drugs revealed by high-throughput deep phenotyping." by C. Ector et al. with the corresponding author A.E.Granada.Methodology described in the Methods section of above mentioned manuscript.</p
Fig4_FigS4_FigS7_ToD_Data
No full textData underlying Figures 4, S4 and S7 of the manuscript "Time-of-day effects of drugs revealed by high-throughput deep phenotyping." by C. Ector et al. with the corresponding author A.E.Granada.Methodology described in the Methods section of above mentioned manuscript.</p
Fig3_FigS3_FigS4_DrugSensitivity
No full textData underlying Figures 3, S3 and S4 of the manuscript "Time-of-day effects of drugs revealed by high-throughput deep phenotyping." by C. Ector et al. with the corresponding author A.E.Granada.Methodology described in the Methods section of above mentioned manuscript.</p
Designing role-based view for object-relational databases
No full textIn a federated database system, a view mechanism is crucial since it is used to define exportable subsets of data ; to perform a virtual restructuring d ataset; and to construct the integrated schema. The view service in federated databa se systems must be capable of retaining as much semantic information as possible. The object-oriented ( 0 - 0 ) model was considered the suitable canonical data model since it meets the original criteria for canonical model selection. However, with the emergence of stronger object-relational (0 -R ) model, the re is a clear argument for using an 0 - R canonical model in the federation. Hence, research should now focus on th e development of semantically powerful view mechanism for th e newer model. Meanwhile, the availability of real 0 -R technologies offers researchers the opportunity to develop different forms of view mechanisms.
The concept of roles has been widely studied in 0 - 0 modelling and development. The role model represents some characteristics that the traditional 0-0 model lacked, such as object migration, multiple occurrences and context-dependent access. While many forms of 0-0 views were designed for the 0-0 canonical model, one option was to extend the 0-0 model to incorporate a role model. In a role model, the real entity is modelled in the form of a role rather than an object. An object represents the permanent properties of an entity is a root object; and an object represents the temporary properties of an entity is a role object.
The contribution of this research is to design a view system that employees the concept of roles for the 0 -R canonical model in a federated database system. In this thesis, an examination of the current 0 -R metamodel is provided first in order to provide an environment for recognising the roleview metadata and measuring the view performance; then a Roleview Definition Language (RDL) is introduced, along with the semantics for defining virtual classes and generating virtua l extents; finally, a working prototype is provided to prove th e role-based view system is implementable and the syntax is semantically correct
