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7 results

  • Home-based telerehabilitation software systems for remote supervising: a systematic review

  • Mohammad Hosseiniravandi, Amir H Kahlaee, Hesam Karim, Leila Ghamkhar, Reza Safdari
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 36 / Issue 2 / April 2020
    Published online by Cambridge University Press:
    10 March 2020, pp. 113-125
  • Objectives

    In the past decade, with the ever-increasing growth of information and communication technologies, telerehabilitation, especially home-based rehabilitation (HBR), has been widely considered by researchers. Many software systems are developed to address HBR programs, which includes various functionalities. The aim of this study is to review the functional features of these systems designed for remote supervising of HBR programs.

    Methods

    Scopus, PubMed, EMBASE, ISI Web of Science, Cochrane Library, IEEE Xplore Digital Library, and ProQuest databases were searched for English-language articles published between January 2008 and February 2018 to retrieve studies reported an home-based telerehabilitation software system aiming to remotely supervise HBR program.

    Results

    A total of fifty studies that reported twenty-two unique systems met the inclusion criteria. Various functional features were identified including but not limited to exercise plan management, report/statistics generating, patient education, and task scheduling. Disorders or diseases addressed by these systems could mainly be grouped into five categories: musculoskeletal, neurological, respiratory, cardiovascular, and other health-related problems. Usability and acceptability, and clinical/patient outcomes were the most reported outcomes and data analysis was used by the majority of included studies to measure the outcomes.

    Conclusions

    Systems developed for supervising of HBR program are diverse. However, preliminary results of this review revealed that these systems share more or less common functionalities. However, further research is needed to determine the requirements, structure, and effectiveness of these systems in real-life settings.

  • Recent Advances in Medical Device Triage Technologies for Chemical, Biological, Radiological, and Nuclear Events

  • Krystal Lansdowne, Christopher G. Scully, Loriano Galeotti, Suzanne Schwartz, David Marcozzi, David G. Strauss
  • Journal:
    Prehospital and Disaster Medicine / Volume 30 / Issue 3 / June 2015
    Published online by Cambridge University Press:
    14 April 2015, pp. 320-323
    Print publication:
    June 2015

  • In 2010, the US Food and Drug Administration (Silver Spring, Maryland USA) created the Medical Countermeasures Initiative with the mission of development and promoting medical countermeasures that would be needed to protect the nation from identified, high‐priority chemical, biological, radiological, or nuclear (CBRN) threats and emerging infectious diseases. The aim of this review was to promote regulatory science research of medical devices and to analyze how the devices can be employed in different CBRN scenarios. Triage in CBRN scenarios presents unique challenges for first responders because the effects of CBRN agents and the clinical presentations of casualties at each triage stage can vary. The uniqueness of a CBRN event can render standard patient monitoring medical device and conventional triage algorithms ineffective. Despite the challenges, there have been recent advances in CBRN triage technology that include: novel technologies; mobile medical applications (“medical apps”) for CBRN disasters; electronic triage tags, such as eTriage; diagnostic field devices, such as the Joint Biological Agent Identification System; and decision support systems, such as the Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST). Further research and medical device validation can help to advance prehospital triage technology for CBRN events.

    Lansdowne K, Scully CG, Galeotti L, Schwartz S, Marcozzi D, Strauss DG. Recent Advances in Medical Device Triage Technologies for Chemical, Biological, Radiological, and Nuclear Events. Prehosp Disaster Med. 2015;30(3):1-4

  • Conservative management of vestibular schwannomas of 15 to 31 mm intracranial diameter

  • C E E Reddy, H G Lewis-Jones, M Javadpour, I Ryland, T H J Lesser
  • Journal:
    The Journal of Laryngology & Otology / Volume 128 / Issue 9 / September 2014
    Published online by Cambridge University Press:
    14 August 2014, pp. 752-758
    Print publication:
    September 2014
  • Objective:

    To study the natural course of vestibular schwannomas 15 to 31 mm in diameter.

    Methods:

    A retrospective study of 45 patients conservatively managed with interval scanning was performed. Outcome measures were: changes in tumour size, clinical features and hearing. A tumour was considered to be growing if it increased in size by more than 2 mm.

    Results:

    Initial tumour sizes ranged from 15 to 31 mm, with a mean (± standard deviation) diameter of 20.1 ± 4.3 mm. The duration of follow up ranged from 6 months to 14 years (median, 3 years). Tumours grew in 11 cases (24.4 per cent), remained stable in 30 cases (66.7 per cent) and regressed in 4 cases (8.9 per cent). The overall mean tumour growth rate was 0.9 ± 2.2 mm per year; in growing tumours, it was 3.6 ± 2.9 mm per year.

    Conclusion:

    Outcomes were similar to those reported for smaller tumours. These findings suggest that patients with medium or moderately large tumours can be safely offered an initial period of conservative management before intervention is considered.

  • Chapter 21 - Sedation in dentistry

  • Edited by Richard D. Urman, Alan D. Kaye
  • Book:
    Moderate and Deep Sedation in Clinical Practice
    Published online:
    05 March 2012
    Print publication:
    09 February 2012, pp 254-280

  • Summary

    An integral part of the practice of gastrointestinal endoscopy is adequate sedation and analgesia. The choice of the appropriate sedation modality is always a balance between optimizing the benefits of sedation and minimizing the potential risks. The American Society of Anesthesiologists (ASA) agrees that appropriate pre-procedure evaluation increases the likelihood of satisfactory sedation and decreases the likelihood of adverse outcomes. A vast majority of endoscopic procedures are diagnostic in nature and performed on relatively healthy patients with an ASA status of 1 or 2. Diagnostic and therapeutic endoscopic interventions include esophagogastroduodenoscopy (EGD), proctoscopy/sigmoidoscopy/colonoscopy, and endoscopic retrograde cholangiopancreatography (ERCP). Sedation for gastrointestinal endoscopy is particularly challenging because of variability during most procedures, characterized by long nonstimulating periods interspersed with significantly stimulating events. Use of a medication reconciliation tool is associated with significant improvements in patient safety.

  • Chapter 24 - Emergency resuscitation algorithms: adults

  • Edited by Richard D. Urman, Alan D. Kaye
  • Book:
    Moderate and Deep Sedation in Clinical Practice
    Published online:
    05 March 2012
    Print publication:
    09 February 2012, pp 300-306

  • Summary

    This chapter emphasizes thorough patient evaluation to identify appropriate intensive care unit (ICU) sedation candidates, and reviews common indications for ICU sedation administration. It examines the risks inherent in under- and oversedation, and reviews the basic pharmacology and administration techniques of commonly utilized ICU sedatives and analgesics. Specific sedatives and analgesics have known pharmacologic effects on contractility, vascular tone, and sympathetic-parasympathetic balance. Certain sedative medications rely upon hepatic inactivation or have active metabolites that require renal elimination. The chapter describes the sedation scales to guide ongoing sedation administration and minimize the chance of under- or oversedation. Cerebral function monitors (CFMs) are primarily utilized in the operating room to monitor anesthesia levels and minimize patient recall of unpleasant intraoperative events. They have yet to be widely accepted for ICU sedation monitoring, and little correlation exists between sedation scale and bispectral index (BIS) readings.