The adoption of Internet of Things devices and, more in general, embedded systems, endowed with sensors and actuators, keeps rising globally, and the scope of their involvement broadens, for instance ...in e-Health applications. This work describes our integration of IoT paradigms and resource ecosystems with a tailored Cloud-oriented device-centric environment, by focusing on an e-Health scenario, featuring monitoring and early treatment of hospitalized patients, by focusing on Cloud-enabled event detection coupled with coordinated reaction.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This study was conducted to determine COPD severity at the time of diagnosis as confirmed by spirometry in patients treated in a US managed care setting.
All patients with one or more inpatient ...stays, one or more emergency department visits, or two or more outpatient visits with diagnosis codes for COPD during 1994-2006 were identified from the Lovelace Patient Database. From this group, a subset of continuously enrolled patients with evidence in claims of a first available pulmonary function test or pulmonary clinic visit and a confirmatory claim for a COPD diagnosis was selected. Medical chart abstraction was undertaken for this subset to gather information for diagnosis and severity staging of each patient based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD.
Of the 12,491 patients with a primary or secondary COPD diagnosis between 1994 and 2006, there were 1520 continuously enrolled patients who comprised the study cohort. Among the 648 eligible records from patients with evidence of a pulmonary function test, 366 were identified by spirometry as having COPD of GOLD stage I or higher (average percentage of predicted forced expiratory volume in 1 second: 60%): 19% were diagnosed at the stage of mild disease (GOLD stage I); 50% at moderate disease (GOLD stage II); and 31% at severe or very severe disease (GOLD stage III or IV, respectively). The majority of patients in these groups were not receiving maintenance treatment.
The results demonstrate a very low incidence of early-stage diagnosis, confirmed by a pulmonary function test, of COPD in a large US sample and support calls for increased screening for COPD and treatment upon diagnosis.
In the 18th and 19th centuries, dentists ‘‘straightened’’ the teeth of adolescents and adults. Angle had suggested that earlier treatment would be advisable but presented very few examples of this ...approach. In 1912, E. A. Bogue was the first orthodontist to publish articles advocating treatment for children before they reached the age of six by widening arches to create diastemas between temporary teeth and, above all, by eliminating mouth breathing.
The aim of this study was to assess the orthodontic treatment effects on unilateral posterior crossbite in the primary and early mixed dentition by systematically reviewing the literature. A ...literature search was performed by applying the Medline database (Entrez PubMed) and covering the period from January 1966 to October 2002. The inclusion criteria were primary and early mixed dentition with unilateral posterior crossbite, randomized controlled trials (RCT), prospective and retrospective studies with concurrent untreated as well as normal controls, and clinical trials comparing at least two treatment strategies without any untreated or normal group involved. Two reviewers extracted the data independently and also assessed the quality of the studies. The search strategy resulted in 1001 articles, and 12 met the inclusion criteria. Two RCTs of early treatment of crossbite have been performed, and these two studies support grinding as treatment in the primary dentition. There is no scientific evidence available to show which of the treatment modalities, grinding, Quad-helix, expansion plates, or rapid maxillary expansion, is the most effective. Most of the studies have serious problems of lack of power because of small sample size, bias and confounding variables, lack of method error analysis, blinding in measurements, and deficient or lack of statistical methods. To obtain reliable scientific evidence, better-controlled RCTs with sufficient sample sizes are needed to determine which treatment is the most effective for early correction of unilateral posterior crossbite. Future studies should also include assessments of long-term stability as well as analysis of costs and side effects of the interventions.
Infantile spasms (IS) is a rare and devastating form of early childhood epilepsy. Two drugs are approved in the United States for treatment of IS, H.P. Acthar
Gel (repository corticotropin injection, ...RCI) and Sabril
(vigabatrin). Given real-world variation in treatment of patients with IS, this study characterized treatment patterns with IS medications and determined all-cause health care resource utilization (HCRU) during the 90 days before initiating therapy with RCI in patients with IS.
Truven Health MarketScan
Research Databases were used to identify commercially insured US patients <2 years of age at RCI initiation with an IS diagnosis, per label use, from 1/1/07 to 12/31/15; presence of an electroencephalogram following diagnosis was required to assure diagnosis. Diagnosis codes and dispensed IS treatments of interest (drug classes including corticosteroids, vigabatrin, and other antiepileptic drugs AEDs excluding vigabatrin) before RCI initiation were evaluated.
The 5 most common diagnoses other than IS observed in the study cohort (n=422) were "other convulsions," "acute upper respiratory infection," "esophageal reflux," "epilepsy, unspecified," and "abnormal involuntary muscle movements." Among the study cohort, 51.7% received RCI first; 38.9% received 1 drug class and 9.5% received >1 drug class before RCI initiation. Other AEDs were dispensed most often, either alone (31.3%) or with other drug classes (9.3%). Mean HCRU included 11.8 all-cause outpatient visits and 4.5 medications dispensed. Patients who received RCI or corticosteroids as their initial IS treatment had the lowest and second-lowest HCRU.
In the 90 days before initiating RCI, patients with IS received multiple diagnoses and treatments, characterized by frequent HCRU. Use of RCI first (no prior IS medications) and AEDs first were associated with the lowest and highest HCRU, respectively, across all categories (all-cause outpatient visits, emergency department visits, hospital admissions, prescription medications).
This study assessed the efficacy of sumatriptan 50- and 100-mg tablets in the treatment of migraine attacks while the pain is mild rather than moderate/severe.
Results from The Spectrum Study ...suggested that early treatment of migraine attacks with sumatriptan 50-mg tablets while the pain is mild might enhance painfree response and reduce headache recurrence.
Retrospective analyses of headaches treated during mild pain were performed using data from 3 studies of sumatriptan tablets (protocols S2CM09, S2BT25, and S2BT26). Our primary interest was pain-free response 2 and 4 hours after dosing; secondary interests were use of a second dose of medication, clinical disability (as measured on a 4-point disability scale), migraine-associated symptoms, meaningful pain relief (patient defined), time to meaningful relief, sustained pain-free response, and proportion of attacks in which pain had worsened 2 and 4 hours after dosing, all of which were compared in headaches treated during mild versus moderate/severe pain.
In S2CM09, 92 patients treated 118 headaches during mild pain. Rates of pain-free response were higher 2 hours after dosing with sumatriptan 50 mg (51%) or 100 mg (67%;
P < 0.05) compared with placebo (28%), and were higher with early treatment of mild pain compared with treatment of moderate/severe pain at 2 hours (sumatriptan 50 mg: mild pain, 51%; moderate/severe pain, 31%;
P < 0.05; sumatriptan 100 mg: mild pain, 67%; moderate/severe pain, 36%) and 4 hours (50 mg: 75% vs 56%; 100 mg: 90% vs 61%;
P < 0.05). Early intervention also resulted in less redosing than when moderate/severe pain was treated (50 mg: 21% vs 32%; 100 mg: 20% vs 29%). More attacks treated early with sumatriptan 50 or 100 mg were associated with normal function 4 hours after dosing compared with placebo (70% and 93% vs 46%, respectively). Sustained pain-free response rates 2 to 24 hours after early dosing with sumatriptan 50 or 100 mg were also higher (34% and 53%, respectively) compared with treatment of moderate/severe pain (19% and 24%, respectively). Early treatment with sumatriptan 100 mg produced significantly higher pain-free rates at 2 hours after dosing (
P < 0.001) than did ergotamine plus caffeine (S2BT25: 69% vs 34%, respectively) or aspirin plus metoclopramide (S2BT26: 73% vs 25%, respectively).
Sumatriptan 50- and 100-mg tablets are effective whether pain is mild or moderate/severe. However, treatment with sumatriptan while pain is mild provides high pain-free response rates while reducing the need for redosing, benefits not seen with ergotamine plus caffeine or aspirin plus metoclopramide.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To analyze the efficacy of endoscopic screening for esophageal cancer in high risk population from high risk areas in order to provide scientific basis for evaluation of the results of early ...diagnosis and treatment of esophageal cancer.
Ten high incidence cities and counties of esophageal cancer in Sichuan province were included in this study. Subjects aged 40-69 years were selected to participate in the endoscopic screening based on the cluster sampling, and the screening-positive subjects were further confirmed by pathological examination.
A total of 105 561 subjects were screened during 2006-2014 in 10 cities and counties in Sichuan Province. The detection rate of precancerous lesions was 5.53% (5 841/105 561), and the positive detection rate was 1.13% (1 193/105 561). The overall detection rates of low-grade hyperplasia, moderate hyperplasia, high-grade hyperplasia/carcinoma in situ, early esophageal cancer and invasive carcinoma were 3.87% (4 089/105 561), 1.66% (1 752/105 561), 0.77% (816/105 561), 0.08% (84/105 561) and 0.28% (293/105 561), respectively. The detection rates of all lesions in males were significantly higher than those in females (
<0.05), and were gradually increased with age (
<0.05).
At these ten cities and counties in Sichuan Province with high incidence of esophageal cancer, the endoscopic screening has good effect. There are considerable numbers of patients aged 40-69 with precancerous lesions from the high risk areas. Improving the follow-up work of the population with precancerous lesions will achieve better results of early diagnosis and early treatment.
BACKGROUND: Ninety-five millions of Pakistan's 161 million people, roughly 60% of Pakistan’s population live in malaria endemic regions. Despite a well-established malaria control programme, 500,000 ...malaria infections and 50,000 malaria-attributable deaths occur each year in Pakistan. In Pakistan 15% population lives in high transmission area, 84% in low transmission and 1% in malaria free area, with 64% vivax and 36% Falciparum infections. OBJECTIVE: The objective of this study was to assess the therapeutic efficacy and safety of Dihydroartemisinin-piperaquine (DP) for the treatment of uncomplicated Plasmodium vivax malaria in subjects. METHODS: Its an observational study, conducted at Outpatient Department of Liaquat University Hospital Hyderabad, from December 2012 to December 2013. World Health Organization (WHO) standard protocol for efficacy studies (open-labelled clinical trial) was followed. The subjects with fever or history of fever for 48 hours aged between 6 months to 15 years with microscopically confirmed uncomplicated P. vivax infection were included. Total 109 patients fulfilled the inclusion criteria. Out of 109 patients, 103 had completed the study. Patients were treated with Dihydroartemisinin-piperaquine over three days. Clinical and parasitological parameters were monitored over a 42-days follow-up period to evaluate drug therapeutic efficacy. RESULTS: Adequate clinical and parasitological response of treatment (ACPR) for Dihydroartemisinin-piperaquine (DP) was seen in 102/103 (99.02%) patients, no early or late clinical failure was seen while late parasitological failure was seen on 21st day in one patient. No adverse events were reported. CONCLUSION: Dihydroartemisinin-piperaquine is safe and effective treatment option for uncomplicated vivax malaria.
Acute hypertensive response is common in patients with
intracerebral hemorrhage and it is believed to increase mortality by
causing hematoma enlargement. In order to prove this hypothesis, the
...“Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage
Trial-2 (INTERACT-2)” was performed (data from this study was
published in the 3rd issue of Turkish Journal of Neurology in 2013).
Interestingly, this study demonstrated that intensive antihypertensive
treatment applied within 6 hours after the start of acute cerebral
hemorrhage symptoms did not change rates of death or severe
disability; however, disability scores were lower and quality of life was
better in patients who took intensive antihypertensive treatment (1).
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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