Applications

Applications
  • 文章类型: Journal Article
    这篇综述强调了MIP-CM的基本原理,并系统地总结了它们的合成策略和应用,和潜在的发展。MIP-CM因其多功能性而广受赞誉,在分离中寻找应用,过滤,检测,和痕量分析,以及在一系列分析中充当支架,生物医学和工业背景。还具有非凡的选择性,非凡的灵敏度,和杰出的结合分子的能力,这些膜也很划算,高度稳定,并且在识别方面是可配置的,因此,在各种应用领域不可分离。与论文的潜在未来有关的问题在最后一节中进行了讨论,重点是提高不同领域的资源实际应用。因此,这篇评论可以看作是一种设计和制造MIP-CM的食谱,旨在扩大其应用范围。
    This review underscores the fundamentals of MIP-CMs and systematically summarizes their synthetic strategies and applications, and potential developments. MIP-CMs are widely acclaimed for their versatility, finding applications in separation, filtration, detection, and trace analysis, as well as serving as scaffolds in a range of analytical, biomedical and industrial contexts. Also characterized by extraordinary selectivity, remarkable sensitivity, and outstanding capability to bind molecules, those membranes are also cost-effective, highly stable, and configurable in terms of recognition and, therefore, inalienable in various application fields. Issues relating to the potential future for the paper are discussed in the last section with the focus on the improvement of resource practical application across different areas. Hence, this review can be seen as a kind of cookbook for the design and fabrication of MIP-CMs with an intention to expand the scope of their application.
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  • 文章类型: Journal Article
    杜仲(EU)是中国原产于冰河时代的珍贵树种。该物种具有重要的经济价值和综合发展潜力,特别是在医疗应用中。欧盟的药用部分是其树皮(杜仲皮层)和叶(杜仲叶),自公元前一世纪以来,它们已被连续用作中药治疗疾病。在过去的20年里,随着天然多糖对药理学的兴趣越来越大,生物医学,化妆品和食品应用,越来越多的学者也开始研究欧盟多糖。已经发现欧盟多糖在体内和体外都具有多种生物学功能,包括免疫调节,抗氧化剂,抗炎,反互补,抗疲劳,和肝保护活动。这篇综述旨在总结提取方面的这些最新进展,净化,结构特征,欧盟树皮和叶多糖的药理活性及其在不同领域的应用。发现杜仲叶多糖和杜仲叶多糖均适合药用。在免疫调节和抗氧化活性方面,杜仲叶有可能替代杜仲叶。本研究对提高欧盟多糖的综合利用水平,进一步促进欧盟多糖的应用具有一定的参考价值。
    Eucommia ulmoides (EU) is a precious tree species native to China originating during the ice age. This species has important economic value and comprehensive development potential, particularly in medicinal applications. The medicinal parts of EU are its bark (Eucommiae cortex) and leaves (Eucommiae folium) which have been successively used as a traditional Chinese medicine to treat diseases since the first century BC. During the last 2 decades, as natural polysaccharides have become of increasing interest in pharmacology, biomedicine, cosmetic and food applications, more and more scholars have begun to study polysaccharides derived from EU as well. EU polysaccharides have been found to have a variety of biological functions both in vivo and in vitro, including immunomodulatory, antioxidant, anti-inflammatory, anticomplementary, antifatigue, and hepatoprotective activities. This review aims to summarize these recent advances in extraction, purification, structural characteristics, pharmacological activities and applications in different fields of EU bark and leaf polysaccharides. It was found that both Eucommiae folium polysaccharides and Eucommiae cortex polysaccharides were suitable for medicinal use. Eucommiae folium may potentially be used to substitute for Eucommiae cortex in terms of immunomodulation and antioxidant activities. This study serves as a valuable reference for improving the comprehensive utilization of EU polysaccharides and further promoting the application of EU polysaccharides.
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  • 文章类型: Journal Article
    吸入纳米颗粒(NP)治疗在临床和药效学领域提出了复杂的挑战。最近的进步彻底改变了NP技术,使不同分子的结合,从而规避全身清除机制,增强药物有效性,同时减轻全身副作用。尽管系统性NP在肿瘤学和其他学科中取得了成功,吸入NP疗法的探索仍处于起步阶段.负载有支气管扩张剂或抗炎剂的NPs显示出在整个支气管树中精确分布的有希望的潜力。为呼吸系统疾病提供有针对性的治疗。本文对NP在呼吸医学中的应用进行了全面的综述,突出他们的优点,从高度的稳定性到严格的肺特异性递送。它还探索了优化NP加载气溶胶系统的尖端技术,辅以从临床试验中收集到的见解。此外,这篇综述探讨了基于NP的治疗的当前挑战和未来前景.通过综合当前的数据和观点,这篇文章强调了NP介导的药物递送在解决慢性疾病如慢性阻塞性肺疾病方面的转型前景,一个紧迫的全球健康问题在死亡率中排名第三。本概述阐明了NP吸入疗法的不断发展的景观,为推进呼吸医学和改善患者预后提供乐观的途径。
    Inhaled nanoparticle (NP) therapy poses intricate challenges in clinical and pharmacodynamic realms. Recent strides have revolutionized NP technology by enabling the incorporation of diverse molecules, thus circumventing systemic clearance mechanisms and enhancing drug effectiveness while mitigating systemic side effects. Despite the established success of systemic NP delivery in oncology and other disciplines, the exploration of inhaled NP therapies remains relatively nascent. NPs loaded with bronchodilators or anti-inflammatory agents exhibit promising potential for precise distribution throughout the bronchial tree, offering targeted treatment for respiratory diseases. This article conducts a comprehensive review of NP applications in respiratory medicine, highlighting their merits, ranging from heightened stability to exacting lung-specific delivery. It also explores cutting-edge technologies optimizing NP-loaded aerosol systems, complemented by insights gleaned from clinical trials. Furthermore, the review examines the current challenges and future prospects in NP-based therapies. By synthesizing current data and perspectives, the article underscores the transformative promise of NP-mediated drug delivery in addressing chronic conditions such as chronic obstructive pulmonary disease, a pressing global health concern ranked third in mortality rates. This overview illuminates the evolving landscape of NP inhalation therapies, presenting optimistic avenues for advancing respiratory medicine and improving patient outcomes.
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  • 文章类型: Journal Article
    了解肌肉骨骼疼痛的原因和机制对于开发有效的治疗方法和改善患者预后至关重要。自我报告措施,如疼痛绘图比例尺,涉及个人对他们的疼痛程度进行评分。在这项技术中,个人在他们经历疼痛的区域涂色,并且基于所描绘的疼痛强度对所得到的图片进行评级。分析疼痛绘图(PD)通常涉及测量疼痛区域的大小。有几项研究专注于评估PD的临床使用,现在,随着数字PD的引入,这些平台的可用性和可靠性需要验证。传统和数字PD之间的比较研究显示出良好的一致性和可靠性。过去20年来,PD收购的演变反映了数字技术的商业化。然而,笔在纸上的方法似乎更被患者接受,但是目前没有用于扫描PD的标准化方法。
    这项研究的目的是评估使用各种数字扫描仪通过网络平台进行的PD分析的准确性。主要目标是证明简单且负担得起的移动设备可用于获取PD而不会丢失重要信息。
    生成了两组PD:一组增加了216个彩色圆圈,另一组由在成年男性的正面视图身体图上随机分布的各种红色形状组成。然后将这些图纸以彩色打印在A4纸上,包括角落的QR码,以允许自动对齐,并随后使用不同的设备和应用进行扫描。使用的扫描仪是不同尺寸和价格的平板扫描仪(专业,便携式平板,和家用打印机或扫描仪),不同价格范围的智能手机,和6个虚拟扫描仪应用程序。由相同的操作者在正常光条件下进行采集。
    高饱和度颜色,如红色,青色,洋红色,黄色,被所有设备准确识别。小的百分比误差,中等,所有设备的大痛点始终低于20%,较小的值与较大的区域相关联。此外,误差百分比与斑点大小之间存在显著负相关(R=-0.237;P=.04).所提出的平台被证明是健壮和可靠的,可以通过各种扫描设备获取纸质PD。
    这项研究表明,Web平台可以准确地分析通过各种数字扫描仪获取的PD。研究结果支持使用简单且具有成本效益的移动设备进行PD采集,而不会影响数据质量。使用所提出的平台标准化扫描过程可以有助于在临床和研究环境中更有效和一致的PD分析。
    UNASSIGNED: Understanding the causes and mechanisms underlying musculoskeletal pain is crucial for developing effective treatments and improving patient outcomes. Self-report measures, such as the Pain Drawing Scale, involve individuals rating their level of pain on a scale. In this technique, individuals color the area where they experience pain, and the resulting picture is rated based on the depicted pain intensity. Analyzing pain drawings (PDs) typically involves measuring the size of the pain region. There are several studies focusing on assessing the clinical use of PDs, and now, with the introduction of digital PDs, the usability and reliability of these platforms need validation. Comparative studies between traditional and digital PDs have shown good agreement and reliability. The evolution of PD acquisition over the last 2 decades mirrors the commercialization of digital technologies. However, the pen-on-paper approach seems to be more accepted by patients, but there is currently no standardized method for scanning PDs.
    UNASSIGNED: The objective of this study was to evaluate the accuracy of PD analysis performed by a web platform using various digital scanners. The primary goal was to demonstrate that simple and affordable mobile devices can be used to acquire PDs without losing important information.
    UNASSIGNED: Two sets of PDs were generated: one with the addition of 216 colored circles and another composed of various red shapes distributed randomly on a frontal view body chart of an adult male. These drawings were then printed in color on A4 sheets, including QR codes at the corners in order to allow automatic alignment, and subsequently scanned using different devices and apps. The scanners used were flatbed scanners of different sizes and prices (professional, portable flatbed, and home printer or scanner), smartphones with varying price ranges, and 6 virtual scanner apps. The acquisitions were made under normal light conditions by the same operator.
    UNASSIGNED: High-saturation colors, such as red, cyan, magenta, and yellow, were accurately identified by all devices. The percentage error for small, medium, and large pain spots was consistently below 20% for all devices, with smaller values associated with larger areas. In addition, a significant negative correlation was observed between the percentage of error and spot size (R=-0.237; P=.04). The proposed platform proved to be robust and reliable for acquiring paper PDs via a wide range of scanning devices.
    UNASSIGNED: This study demonstrates that a web platform can accurately analyze PDs acquired through various digital scanners. The findings support the use of simple and cost-effective mobile devices for PD acquisition without compromising the quality of data. Standardizing the scanning process using the proposed platform can contribute to more efficient and consistent PD analysis in clinical and research settings.
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  • 文章类型: Journal Article
    近年来,人工智能(AI)在医疗保健中的实施正在逐步改变医疗领域,使用临床决策支持系统(CDS)作为一个值得注意的应用。实验室检查对准确诊断至关重要,但是他们日益依赖带来了挑战。从每月对测试结果的数百万次搜索中可以明显看出,需要有效的策略来管理实验室测试解释。随着CDS在实验室诊断中的潜在作用越来越重要,然而,需要更多的研究来探索这个领域。
    我们研究的主要目的是评估LabTestChecker(LTC)的准确性和安全性,CDSS旨在通过分析实验室检查结果和患者病史来支持医疗诊断。
    这项队列研究采用了前瞻性数据收集方法。共有101名年龄≥18岁的患者,在稳定状态下,并要求综合诊断。对每个参与者进行一组血液实验室测试。参与者使用LTC解释测试结果。通过将AI生成的建议与经验丰富的医生(顾问)建议进行比较,来评估该工具的准确性和安全性。这被认为是黄金标准。
    该系统在紧急安全方面达到了74.3%的准确性和100%的灵敏度,在紧急情况下达到了92.3%的灵敏度。它可能减少了41.6%(42/101)的不必要的医疗访问,并在识别潜在病理方面实现了82.9%的准确性。
    这项研究强调了基于AI的CDS在实验室诊断中的变革潜力,有助于加强病人护理,高效的医疗保健系统,改善医疗结果。LTC的绩效评估突出了AI在实验室医学中的作用。
    UNASSIGNED: In recent years, the implementation of artificial intelligence (AI) in health care is progressively transforming medical fields, with the use of clinical decision support systems (CDSSs) as a notable application. Laboratory tests are vital for accurate diagnoses, but their increasing reliance presents challenges. The need for effective strategies for managing laboratory test interpretation is evident from the millions of monthly searches on test results\' significance. As the potential role of CDSSs in laboratory diagnostics gains significance, however, more research is needed to explore this area.
    UNASSIGNED: The primary objective of our study was to assess the accuracy and safety of LabTest Checker (LTC), a CDSS designed to support medical diagnoses by analyzing both laboratory test results and patients\' medical histories.
    UNASSIGNED: This cohort study embraced a prospective data collection approach. A total of 101 patients aged ≥18 years, in stable condition, and requiring comprehensive diagnosis were enrolled. A panel of blood laboratory tests was conducted for each participant. Participants used LTC for test result interpretation. The accuracy and safety of the tool were assessed by comparing AI-generated suggestions to experienced doctor (consultant) recommendations, which are considered the gold standard.
    UNASSIGNED: The system achieved a 74.3% accuracy and 100% sensitivity for emergency safety and 92.3% sensitivity for urgent cases. It potentially reduced unnecessary medical visits by 41.6% (42/101) and achieved an 82.9% accuracy in identifying underlying pathologies.
    UNASSIGNED: This study underscores the transformative potential of AI-based CDSSs in laboratory diagnostics, contributing to enhanced patient care, efficient health care systems, and improved medical outcomes. LTC\'s performance evaluation highlights the advancements in AI\'s role in laboratory medicine.
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  • 文章类型: Journal Article
    外泌体在各种生物过程中起着至关重要的作用,比如人类的发展,免疫反应,和疾病的发生。外泌体上的膜蛋白是其生物学功能的关键因素。目前,已经在外泌体膜上鉴定了许多膜蛋白,参与细胞间通讯,介导靶细胞识别,和调节免疫过程。此外,来自癌细胞外泌体的膜蛋白可以作为早期癌症诊断的相关生物标志物。本文综述了外泌体膜蛋白的组成及其在生物体生物过程中的不同功能。通过对外泌体膜蛋白的深入探索,它有望为未来新型生物医学诊断和治疗的发展提供必要的基础。
    Exosomes play a crucial role in various biological processes, such as human development, immune responses, and disease occurrence. The membrane proteins on exosomes are pivotal factors for their biological functionality. Currently, numerous membrane proteins have been identified on exosome membranes, participating in intercellular communication, mediating target cell recognition, and regulating immune processes. Furthermore, membrane proteins from exosomes derived from cancer cells can serve as relevant biomarkers for early cancer diagnosis. This article provides a comprehensive review of the composition of exosome membrane proteins and their diverse functions in the organism\'s biological processes. Through in-depth exploration of exosome membrane proteins, it is expected to offer essential foundations for the future development of novel biomedical diagnostics and therapies.
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  • 文章类型: Journal Article
    背景:数字技术和游戏化应用程序在医疗保健环境中很有用。游戏化使用技术通过类似游戏的体验来影响用户的行为和动机。患者坚持增强术后恢复(ERAS)计划对于实现术后早期恢复至关重要,并且持续监测对于获得良好结果至关重要。
    目的:本研究旨在描述用于增强术后恢复的移动应用程序(MobERAS)的开发和验证,一个游戏化的移动健康应用程序,用于根据ERAS计划在术后期间对患者进行远程监护,并评估其功能和可用性以及患者的体验,卫生保健专业人员,和计算机专业人员使用它。
    方法:我们开发了用于术后远程监测的MobERAS,在患者积极参与的过程中,并为卫生团队提供实时信息。应用程序开发过程包括理想化,跨学科团队组建,潜在需求评估,和产品部署。在整个开发过程中进行了可用性测试,并进行了改进,技术调整,和更新。定稿后,进行了全面的验证试验。评估的参数是那些可以影响住院时间的参数,比如恶心,呕吐,疼痛量表,恢复正常的胃肠功能,和血栓栓塞事件。MobERAS旨在由用户在手机上下载,片剂,或其他移动设备,并提供术后数据。该应用程序有一个GPS,监测患者的步行时间和距离,并连接到存储收集的数据的虚拟数据库。
    结果:纳入接受中型和大型妇科肿瘤手术的妇女。我们纳入了65例患者,平均年龄为53.2岁(SD7.4,范围18-85岁)。使用时间为23.4至70小时(平均45.1,SD19.2小时)。关于坚持使用MobERAS,平均填充率为56.3%(标准差为12.1%,范围41.7%-100%),并获得了65例患者中60例(92.3%)的下床数据。研究人员可以实时访问患者填写的数据。患者很好地接受了MobERAS的使用,与应用程序的可用性的良好评价。MobERAS易于使用,并且由于其游戏化的设计而被认为具有吸引力。该应用程序在所有项目中被医疗保健专业人员(n=20)和专门从事技术创新的专业人员(n=10)评为好或非常好。
    结论:MobERAS易于使用,安全,被患者接受,并得到专家的良好评估。它可以在临床外科实践中非常有用,并且是使患者和医疗保健专业人员更多参与ERAS计划的重要工具。
    BACKGROUND: Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users\' actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results.
    OBJECTIVE: This study aimed to describe the development and validation of a mobile app for enhanced recovery after surgery (MobERAS), a gamified mobile health app for telemonitoring patients in the postoperative period based on the ERAS program, and to evaluate its functionality and usability and the experience of patients, health care professionals, and computer professionals with its use.
    METHODS: We developed MobERAS for postoperative telemonitoring, with active participation of patients in the process, and offering availability of real-time information for the health team. The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return to normal gastrointestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a GPS that monitors the patient\'s walking time and distance and is connected to a virtual database that stores the collected data.
    RESULTS: Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2 (SD 7.4, range 18-85) years. The time of use ranged from 23.4 to 70 hours (mean 45.1, SD 19.2 hours). Regarding adherence to the use of MobERAS, the mean fill rate was 56.3% (SD 12.1%, range 41.7%-100%), and ambulation data were obtained for 60 (92.3%) of the 65 patients. The researcher had access to the data filled out by the patients in real time. There was good acceptance of the use of MobERAS by the patients, with good evaluation of the app\'s usability. MobERAS was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health care professionals (n=20) and professionals specializing in technological innovation (n=10).
    CONCLUSIONS: MobERAS is easy to use, safe, well accepted by patients, and well evaluated by experts. It can be of great use in clinical surgical practice and an important tool for greater engagement of patients and health care professionals with the ERAS program.
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  • 文章类型: Journal Article
    背景:家庭很难为自闭症儿童导航和获得服务。在资源匮乏的家庭中,获得服务的障碍更加复杂。
    目的:我们研究的目的是探索开发一款应用程序,以促进资源匮乏的自闭症儿童家庭获得服务。我们的具体目标是探索咨询委员会对该应用程序的反馈,并探索导航员对该应用程序的反馈。
    方法:通过多阶段共同发展过程,我们从5个关键方得到了反馈:研究团队,一个社区组织,应用开发团队,咨询委员会,和家庭导航员。总的来说,36个人通过个人访谈提供了有关该应用程序开发的反馈,焦点小组,观察,和调查。该应用程序的主要功能包括显示家庭和相关资源的服务需求的仪表板,家庭之间的信息传递功能,航海家,和主管,以及保真度检查表和评估功能。
    结果:顾问委员会提供了有关该应用程序的反馈,以提高其用户友好性,包括制定行动计划的能力,改进对所需服务的识别,并添加有关服务提供商的信息。导航器建议应用程序应该将导航器相互连接,对注释部分有更明确的目的,并反映一个更容易的登录过程。导航员还希望使用该应用程序进行角色扮演培训。使用该应用程序参与角色扮演后,navigators报告对app的满意度明显更高,实用性更高(P<.001)。
    结论:我们的工作揭示了获取最终用户反馈的重要性,特别是那些经常被研究社区和应用程序开发人员忽视的用户。Further,重要的是以多种方式获得反馈来改进应用程序。
    BACKGROUND: It is difficult for families to navigate and access services for their children with autism. Barriers to service access are compounded among families from low-resourced backgrounds.
    OBJECTIVE: The purpose of our study was to explore the development of an app to facilitate access to services among families of children with autism from low-resourced backgrounds. Our specific aims were to explore feedback from an advisory board about the app and to explore feedback from navigators about the app.
    METHODS: Via a multistage codevelopment process, we elicited feedback from 5 key parties: the research team, a community organization, the app development team, the advisory board, and family navigators. Collectively, 36 individuals provided feedback about the development of the app via individual interviews, focus groups, observations, and surveys. The key features of the app included a dashboard showing the service needs of the family and related resources, a messaging feature between the family, the navigator, and the supervisor, and a fidelity checklist and evaluation feature.
    RESULTS: The advisory board provided feedback about the app to increase its user-friendliness, include the ability to develop an action plan, improve the identification of needed services, and add information about service providers. Navigators suggested that the app should connect navigators to one another, have a clearer purpose for the notes section, and reflect an easier log-in process. Navigators also wanted training to role-play using the app. After participating in a role play using the app, navigators reported significantly more satisfaction with the app and greater usefulness (P<.001).
    CONCLUSIONS: Our work sheds light on the importance of eliciting feedback from end users, especially users who are often overlooked by the research community and app developers. Further, it is important to elicit feedback in multiple ways to improve the app.
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  • 文章类型: Journal Article
    手性结构,从纳米尺度到宏观尺度的自然系统的关键结构特征之一,是功能材料的无限灵感来源。研究人员一直以来,现在仍然是,通过简单有效的策略,大力追求使用可再生和可持续的构建模块构建此类结构的目标。凭借高度可持续性的优点,可再生性,以及在水性悬浮液中自组装成手性向列型结构的能力,可以保持固态,包括纤维素纳米晶体(CNCs)和几丁质纳米晶体(ChNCs)的多糖纳米晶体(PNs)提供了到达目标的机会。我们在此提供了全面的综述,重点介绍了用于高级功能材料的CNCs和ChNCs的开发。首先,CNCs和ChNCs的引入,以及自然界中纤维素和几丁质形成的手性向列组织,是给定的。然后,全面讨论了此类PN的自组装过程以及影响该过程的因素。之后,我们展示了CNCs和ChNCs的自组装手性向列结构的新兴应用。最后,这篇综述最后提出了对这一领域面临的挑战和机遇的看法。
    Chiral architectures, one of the key structural features of natural systems ranging from the nanoscale to macroscale, are an infinite source of inspiration for functional materials. Researchers have been, and still are, strongly pursuing the goal of constructing such structures with renewable and sustainable building blocks via simple and efficient strategies. With the merits of high sustainability, renewability, and the ability to self-assemble into chiral nematic structures in aqueous suspensions that can be preserved in the solid state, polysaccharide nanocrystals (PNs) including cellulose nanocrystals (CNCs) and chitin nanocrystals (ChNCs) offer opportunities to reach the target. We herein provide a comprehensive review that focuses on the development of CNCs and ChNCs for the use in advanced functional materials. First, the introduction of CNCs and ChNCs, and cellulose- and chitin-formed chiral nematic organizations in the natural world, are given. Then, the self-assembly process of such PNs and the factors influencing this process are comprehensively discussed. After that, we showcased the emerging applications of the self-assembled chiral nematic structures of CNCs and ChNCs. Finally, this review concludes with perspectives on the challenges and opportunities in this field.
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  • 文章类型: Journal Article
    背景:十年来,尽管有很多研究的结果,由于不同的研究结果,远程医疗系统缺乏对慢性心力衰竭(CHF)护理的建议。另一个限制是大多数远程医疗系统的基于医院的架构。一些系统使用基于每日体重的算法,经皮氧测量,和心率,以尽早发现和治疗CHF患者的急性心力衰竭(AHF)。
    目的:本研究的目的是确定远程监测系统在现实生活中(院外管理)检测临床不稳定而不会产生过多的假阳性警报的有效性。
    方法:回顾性纳入2020年3月至2021年3月在法国心脏病学诊所治疗的充血性AHF事件后,所有患者在家中使用该系统进行自我监测,每天测量的依从性至少为75%。新发作的AHF由以下标准中的至少一个定义:经皮氧饱和度损失,定义为经皮氧测量值低于90%;心跳频率高于每分钟110次;体重增加至少2公斤;和充血性AHF症状,通过电话描述。当标准达到我们对新发急性充血性心力衰竭(HF)的定义时,会生成AHF警报。
    结果:共纳入111名连续患者(n=70名男性),中位年龄76.60岁(IQR69.5-83.4)。三十九名病人(35.1%)达到高频警告水平,28例患者(25%)在随访期间证实了HF失稳。没有患者没有被远程监测系统检测到的AHF。在不正确的AHF警报中(n=11),5名患者(45%)进行了不准确的测量,3例患者(27%)有室上性心律失常,1例患者(9%)有肺部细菌感染,1例患者(9%)感染COVID-19。4天内体重增加至少2公斤与正确的AHF警报显着相关(P=.004),心率超过110次/分钟与错误的AHF警报更显著相关(P=.007)。
    结论:这项单中心研究通过检测新发AHF和室上性心律失常,强调了远程医疗系统在检测和快速治疗复杂CHF病程的心脏不稳定方面的功效。从而帮助心脏病专家为门诊患者提供更好的随访。
    BACKGROUND: For a decade, despite results from many studies, telemedicine systems have suffered from a lack of recommendations for chronic heart failure (CHF) care because of variable study results. Another limitation is the hospital-based architecture of most telemedicine systems. Some systems use an algorithm based on daily weight, transcutaneous oxygen measurement, and heart rate to detect and treat acute heart failure (AHF) in patients with CHF as early on as possible.
    OBJECTIVE: The aim of this study is to determine the efficacy of a telemonitoring system in detecting clinical destabilization in real-life settings (out-of-hospital management) without generating too many false positive alerts.
    METHODS: All patients self-monitoring at home using the system after a congestive AHF event treated at a cardiology clinic in France between March 2020 and March 2021 with at least 75% compliance on daily measurements were included retrospectively. New-onset AHF was defined by the presence of at least 1 of the following criteria: transcutaneous oxygen saturation loss, defined as a transcutaneous oxygen measurement under 90%; rise of cardiac frequency above 110 beats per minute; weight gain of at least 2 kg; and symptoms of congestive AHF, described over the phone. An AHF alert was generated when the criteria reached our definition of new-onset acute congestive heart failure (HF).
    RESULTS: A total of 111 consecutive patients (n=70 men) with a median age of 76.60 (IQR 69.5-83.4) years receiving the telemonitoring system were included. Thirty-nine patients (35.1%) reached the HF warning level, and 28 patients (25%) had confirmed HF destabilization during follow-up. No patient had AHF without being detected by the telemonitoring system. Among incorrect AHF alerts (n=11), 5 patients (45%) had taken inaccurate measurements, 3 patients (27%) had supraventricular arrhythmia, 1 patient (9%) had a pulmonary bacterial infection, and 1 patient (9%) contracted COVID-19. A weight gain of at least 2 kg within 4 days was significantly associated with a correct AHF alert (P=.004), and a heart rate of more than 110 beats per minute was more significantly associated with an incorrect AHF alert (P=.007).
    CONCLUSIONS: This single-center study highlighted the efficacy of the telemedicine system in detecting and quickly treating cardiac instability complicating the course of CHF by detecting new-onset AHF as well as supraventricular arrhythmia, thus helping cardiologists provide better follow-up to ambulatory patients.
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