41 research outputs found
Designing a Testing Environment for the CAPABLE Telemonitoring and Coaching Platform
No full textThe CAPABLE project has been funded by the European Union to develop a telemonitoring and coaching platform improving the quality of life for cancer patients. The platform, based on a multi agent blackboard architecture, is classified as a medical device according to the current EU regulation. Thus it needs extensive tests before being put into service for the planned clinical trials, which calls for a dedicated simulating and testing environment. Materials and Methods: Coordination in CAPABLE is achieved through the Case Manager, a component able to generate and notify events to other interested agent components. For representing and exchanging health care information we have adopted HL7 FHIR as a semantic interoperability standard. Results: FHIR has been exploited to design a structured history of a real patient affected by renal cell carcinoma. A simulator has been developed for automating the whole testing process represented by specific scenarios of the patient's history. Conclusions: The simulator relies on the events produced by the Case Manager for coordinating the agents. This proved to be effective in checking that the agents reactions to new data showing up on the blackboard comply with the expected behavior
Endocrine and physical determinants of bone mass in late postmenopause
No full textTo analyze the relative contribution of endocrine and physical factors to bone mineral density (BMD) in late menopause, we studied biochemical markers of bone turnover as well as sex and calciotropic hormones in 53 women (mean age 61 +/- 5.3 years), 5 to 23 years after natural menopause. BMD was measured at the lumbar spine and proximal femur by dual energy radiography. Stepwise regression analysis showed that age and PTH levels were the two major factors that significantly accounted for spinal BMD, with a final r(2) = 0.27. Plasma androstenedione was the only other variable that contributed, albeit not significantly, to spine BMD increasing the r(2) by 2%. Conversely, body mass was the main contributor to femoral BMD at all sites. While serum calcium and urinary hydroxyproline were significant determinants of neck BMD, urinary hydroxyproline and age provided significant source of variation for trochanteric BMD, and circulating FSH for BMD in the Ward's area. The final models gave r(2) values of 0.35, 0.31, and 0.23, for neck, trochanter and Ward's areas, respectively. Thus, determinants of bone density differentially affect the vertebral and proximal femoral sites. While increasing age and PTH, probably reflecting a subclinical vitamin D deficiency, explain a decreased vertebral bone density, body mass appears to affect mostly the proximal femur. Circulating androgens play a secondary role. A persistently increased bone turnover state is conducive to lower bone density in late postmenopausal women
A possible role of prolactin in maintaining bone mineral density in post-menopausal women.
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[Pregnancy and labor in patients under 17 years of age. Clinico-statistical considerations]
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