The effectiveness of Internet-based blood glucose monitoring system on improving diabetes control in adolescents with type 1 diabetes

Landau Z, Mazor‐Aronovitch K, Boaz M, Blaychfeld‐Magnazi M, Graph‐Barel C, Levek‐Motola N, Pinhas‐Hamiel O. The effectiveness of Internet‐based blood glucose monitoring system on improving diabetes control in adolescents with type 1 diabetes. Objective: To determine whether the use of an Internet‐based blood glucose monitoring system could improve glycemic control in adolescents with type 1 diabetes mellitus (T1DM). Methods: In a randomized, controlled clinical trial, a total of 70 adolescent subjects with T1DM were recruited. Subjects randomized to the intervention group (n = 36) were instructed to submit their blood glucose levels weekly by Internet to the Diabetes Care Team during a period of 6 months. Subjects randomized to the control group (n = 34) did not submit results but were under routine follow‐up. Results: At baseline, patients were 15.1 ± 2.6 years of age with mean HbA1c of 8.3 ± 1.3%. At the 6‐month follow‐up period, no by‐group differences in change from baseline to end of treatment HbA1c levels were detected. In the intervention group, 12/36 did not submit blood glucose levels and were classified as non‐compliant. In a secondary exploratory analysis in which non‐compliant patients were omitted, HbA1c values in the compliant intervention group declined from 8.5 ± 1.7% at baseline to 8.2 ± 1.2% at 6 months, while in the control group HbA1c values increased from 8.2 ± 1.1 to 8.4 ± 1.1%, this difference did not reach statistical significance. Conclusions: An Internet‐based blood glucose monitoring system was not associated with improved glycemic control in adolescents with T1DM. Identification of a sub‐group of compliant subjects who may improve metabolic control by using this tool is needed.     

Image Analysis Approach for Development of a Decision Support System for Detection of Malaria Parasites in Thin Blood Smear Images

This paper describes development of a decision support system for diagnosis of malaria using color image analysis. A hematologist has to study around 100 to 300 microscopic views of Giemsa-stained thin blood smear images to detect malaria parasites, evaluate the extent of infection and to identify the species of the parasite. The proposed algorithm picks up the suspicious regions and detects the parasites in images of all the views. The subimages representing all these parasites are put together to form a composite image which can be sent over a communication channel to obtain the opinion of a remote expert for accurate diagnosis and treatment. We demonstrate the use of the proposed technique for use as a decision support system by developing an android application which facilitates the communication with a remote expert for the final confirmation on the decision for treatment of malaria. Our algorithm detects around 96% of the parasites with a false positive rate of 20%. The Spearman correlation r was 0.88 with a confidence interval of 0.838 to 0.923, p<0.0001.     

New technology–based functional assessment tools should avoid the weaknesses and proliferation of manual functional assessments

BackgroundFormal functional assessment tools for use with older adults have been in widespread use since the 1960s. Instruments have been designed to assess a wide range of different aspects of a person's everyday life. This article seeks to document the evolution of the tools used in such a way as to inform the development of the field.Study Design and SettingThe Medline, CINHAL, and Science Direct databases were searched for relevant literature relating to the functional assessment of older adults. After analysis of initial results, a second-stage search was conducted to find literature relating to the use and validation of instruments found initially.ResultsFour categories of functional assessment instruments were identified for the purposes of this article: basic activities of daily living (ADLs), instrumental ADL, global health scales, and performance-based tests of functional ability. These categories and several of the most widely used tools therein are discussed chronologically to document the evolution of the field.ConclusionsWith the advancement of technology has come the possibility to perform functional assessments in new ways. This outline of the evolution of functional assessment should be of considerable use as researchers seek to design new functional assessments for older adults.     

远程医学的发展对策研究

远程医学是一种新型医疗模式,它运用多种技术实现了远距离医疗、保健和教学等服务。介绍了远程医学的发展现状、系统组成及工作原理,通过对影响远程医学发展的因素进行分析研究后,给出了发展我国远程医学的对策与建议。     

DSA视频流网络直播系统的设计与临床评价

目的 探讨DSA视频流网络直播临床应用的可行性.方法 DSA视频流由高性能的图像采集卡进行采集,利用动态图像专家组标准4(MPEG-4)压缩,结合微软的流媒体处理开发包DirectShow框架技术,通过服务器端的发送过滤器(filter)和客户端的接收filter,再利用网络传输层的传输控制协议(TCP)和用户数据报协议(UDP),实现DSA视频流的网络直播.对24例图像进行采集直播,由有经验的医师对客户端与DSA工作站的视频图像进行对比分析,主观评价每例图像的血管、病变影像特征的显示情况,以及图像的清晰度、对比度、实时有效性.结果 在100 M的局域网中,该方案直播的图像延迟时间≤1 s,24例视频图像中图像品质评价优17例,良5例,中2例.结论 该方案直播DSA视频流,图像清晰度好,延迟时间短,能够达到临床诊断与实时性要求.     

Application of Telemedicine to Sleep Medicine

Polysomnograms (PSGs) in specialized sleep centers with physicians and technicians trained in sleep medicine are still considered to be the most accurate form of diagnosis in patients with sleep disorders. But they are also very costly. Internet online transfer of PSGs from nonstaffed to very well-staffed sleep centers might be a solution in the future to reduce costs.     

移动医疗在压力性损伤患者中的应用进展

目前,国内移动医疗在压力性损伤患者中的应用尚处于起步阶段。本文对移动医疗在压力性损伤患者中的应用现状进行综述,其应用形式主要包括微信平台、互联网、移动应用程序等服务内容,分析其在应用、法律等方面存在的问题及今后努力的方向,以期为移动医疗在我国压力性损伤患者中的推广应用提供借鉴。     

基于远程医疗服务系统的双向转诊实践和研究

针对目前我国社区卫生服务机构与上级医院医疗卫生现状,从优化卫生资源配置角度阐述推行双向转诊的重要性和必要性。基于远程医疗服务系统探讨如何实现双向转诊,实践证实基于远程医疗服务系统的双向转诊成效显著。