289 research outputs found
Data Protection Issues of Integrated Electronic Health Records (EHR)
No full textAn Electronic Health Record (EHR) of a patient in perspective maintains the medical history of the citizen electronically in medical databanks serviced locally or is cloud based. The ownership and the access control should belong to the citizen and this should be done under the supervision of his personal doctor. Audit trails and security measures must be implemented for making sure that EHR systems properly collect, store, retain and use the patient health information for the better service of the citizen when in need of medical treatment. EU and other countries are determined to find solutions, impose policies and standards as to implement EHR at national level and international levels. In this article the main security issues are presented, the EU directives and legislations in data protection and privacy from the use of EHR are considered, and proposed solutions are analyzed. Finally, it is explained why EHR can and should remain a safe tool
A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy
No full textBackground:
Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED.
Methods:
The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens.
These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics.
Results:
The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry.
Conclusions:
The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services
When the Intensive Care Ventilator Technology Reaches the Operating Room: Advancing Ventilation in Anesthesia
No full textOver the last two decades, the advances in ventilatormodalities and technology have revolutionized the mechanicalventilation process. The new anesthesia ventilatorsconstitute adaptations of machines previously used in intensivecare units. In this line, the FLOW-i anesthesia ventilator hasbeen recently developed based on the SERVO-i intensive careventilator platform. However, the FLOW-i behavior has notbeen so far tested in a leaking circuit.In this study we tested FLOW-i, and compared to SERVO-i,in volume-, pressure-, and pressure-regulated volumecontrolledmodes (VC, PC, and PRVC, respectively) withgas flows of 6, 1, and 0.3 L/min, booth in airtight and leakingcircuit.In the airtight system both ventilators behaved similarly.FLOW-i delivered preset tidal volume and maintained ventilationand circuit pressure at the same levels independently ofventilatory mode or fresh gas flow rate. In the face of a leakingcircuit and in PC mode FLOW-i and SERVO-i delivered to thelung model higher tidal volumes (about 90% and 85% of setvalues, respectively) than in VC and PRVC modes. Additionally,delivered tidal volume did not differ from 6 to 0.3 L/min offresh gas flow
Influence of electrical stimulation on the contraction of myotubes in vitro
No full textStudy of skeletal muscle cells in culture stimulated by externally-applied electical pulses with different characteristics, constitutes an interesting and potentially useful field still open to further investigation, in order to identify an electrical stimulation protocol that could be used for an optimal stimulation of single cells. On the other hand, previous researchers have demonstrated the usefulness of computer vision application to
obtain important quantitative information on the deformation, disruption and development of biological tissues.
In this paper, a method to study the influence that different parameters of electrical stimulation have on the contraction of single skeletal muscle cells stimulated in vitro is described. The investigation was carried out by analyzing image sequences of skeletal myotubes in vitro, stimulated through pulses at different frequencies, intensities and widths. The effects of these three pulse characteristics on the cell contraction responses were examined
with the aim of providing a tool that can facilitate the search for an appropriate stimulation protocol that can be used also in clinical applications where prevention of muscle atrophy due to prolonged lack of exercise is desired. The results show that using single electrical stimulation pulses with a long time duration (e.g. 10 ms), as well as a high stimulus amplitude, allows a complete relaxation of the myotubes. In contrast, using a frequency of stimulation higher than 1 Hz prevents complete relaxation leading to sustained contractions
Estimation of the Endotracheal Tube Pressure Drop during HFPV: A Flow-Independent Model
No full textHigh frequency percussive ventilation (HFPV) is a non-conventional ventilatory modality which has provenvery effective and safe in patients with acute respiratory failure. HFPV ventilator measures airway pressure that representsthe sum of the endotracheal tube pressure drop and thetracheal pressure dissipated to inflate a lung. The estimation of the difference between the peak airway and tracheal pressure ΔPp may be very useful to the clinician to avoid lung injury. The aim of this study is to provide a comprehensive solutionfor estimation of ΔPp in adult endotracheal tubes, by developinga flow-independent model, based on endotracheal tube size, ventilator set parameters (i.e. peak pressures, pulsatile frequencies) and patient’s respiratory system resistance andcompliance. The model for the estimation of ΔPp was determinedby using the Least Absolute Shrinkage and SelectionOperator (LASSO) regularized least-squares regression technique.The identified model was successively assessed on testdata set
Remote monitoring for healthcare and for safety in extreme environments
No full textIn this chapter we examine the potential use of remote health monitoring using Body Area Networks (BANs) to support individuals who are working or pursuing recreational activities in extreme environments
Influence of Aging on Short- and Long-term Heart Rate Variability in Patients with Heart Failure
No full textAlong the last years, the number of HRV studies
has been widely grown. The computation of HRV linear and
non-linear parameters allows the quantification of the cardiac
frequency modulation and of the possible link between them
and different pathologies. In the literature, significant variations
of HRV linear and non-linear parameters are described,
with the focus on age related changes in healthy subjects. The
aim of this study is to evaluate the possible presence of age
related changes in HRV parameters in congestive heart failure
(CHF) patients. The RR time series extracted from 80 CHF
patients, divided by age into two groups, have been accurately
analyzed. The results point out a linear influence of age on
characteristic parameters extracted from these patients; the
behaviors of these parameters are opposite to the literature
results obtained in healthy subjects. We hypothesize that this
discrepancy may be due to the RR data selection and to their
pre-processing phase as well as to some clinical factors as the
neuro hormonal imbalance characteristic of the CHF disease
that often produces a sympathetic activation
The effects of specific omega-3 and omega-6 polyunsaturated fatty acids and antioxidant vitamins on gait and functional capacity parameters in patients with relapsing-remitting multiple sclerosis
No full textPatients with multiple sclerosis (MS) are characterized by, among other symptoms, impaired functional capacity and walking difficulties. Polyunsaturated fatty acids (PUFAs) have been found to improve MS patients’ clinical outcomes; however, their effect on other parameters associated with daily living activities need further investigation. The current study aimed to examine the effect of a 24-month supplementation with a cocktail dietary supplement formula, the Neuroaspis™ PLP10, containing specific omega-3 and omega-6 PUFAs and specific antioxidant vitamins on gait and functional capacity parameters of patients with MS. Fifty-one relapsing-remitting MS (RRMS) patients with low disability scores (age: 38.4 ± 7.1 years; 30 female) were randomized 1:1 to receive either a 20 mL daily dose of the dietary formula containing a mixture of omega-3 and omega-6 PUFAs (12,150 mg), vitamin A (0.6 mg), vitamin E (22 mg), and γ-tocopherol (760 mg), the OMEGA group (n = 27; age: 39 ± 8.3 years), or 20 mL placebo containing virgin olive oil, the placebo group (n = 24; age: 37.8 ± 5.3 years). The mean ± SD (standard deviation) Expanded Disability Status Scale (EDSS) score for the placebo group was 2.36 and for the OMEGA group 2.22. All enrolled patients in the study were on Interferon-β treatment. Spatiotemporal gait parameters and gait deviation index (GDI) were assessed using a motion capture system. Functional capacity was examined using various functional tests such as the six-minute walk test (6MWT), two sit-to-stand tests (STS-5 and STS-60), and the Timed Up and Go test (TUG). Isometric handgrip strength was assessed by a dynamometer. Leg strength was assessed using an isokinetic dynamometer. All assessments were performed at baseline and at 12 and 24 months of supplementation. A total of 36 patients completed the study (18 from each group). Six patients from the placebo group and 9 patients from the OMEGA group dropped out from the study or were lost to follow-up. The dietary supplement significantly improved the single support time and the step and stride time (p < 0.05), both spatiotemporal gait parameters. In addition, while GDI of the placebo group decreased by about 10% at 24 months, it increased by about 4% in the OMEGA group (p < 0.05). Moreover, performance in the STS-60 test improved in the OMEGA group (p < 0.05) and there was a tendency for improvement in the 6MWT and TUG tests. Long-term supplementation with high dosages of omega-3 and omega-6 PUFAs (compared to previous published clinical studies using PUFAs) and specific antioxidant vitamins improved some functional capacity and gait parameters in RRMS patients.</p
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