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DOAJ Open Access 2025
Exploring health literacy pertaining to general wellbeing and chronic disease management among population registered within Primary Healthcare System: A Study protocol.

Muslim Abbas Syed, Ahmed Sameer Alnuaimi, Mohamed Ahmed Syed

<h4>Background</h4>Evidence suggests that high level of health literacy among patients is associated with high levels of accessibility to healthcare, better understanding consent-to-treat forms, increased compliance to treatment (particularly in taking medication for longstanding chronic diseases), comprehending general healthcare and improved preventive care and early disease detection, proper use of home medical devices from patients and increased capability of accessing the various channels of health information when required. The proposed study aims to assess and capture preferences and perceptions regarding health literacy of population (registered within primary care clinics in state of Qatar) in context to their general wellbeing (physical and mental health) and management of chronic disease conditions.<h4>Methods</h4>The study design will be mixed methods (include both quantitative and qualitative elements). The HLQ survey will be sent online (text messages) to the population registered with PHCC and to capture service users' perceptions and preferences pertaining to health literacy channels. The qualitative method will be utilized to gain an in-depth understanding of the various health literacy channels, challenges and barriers pertaining to the implementation of the health literacy strategies from both the healthcare provider and service users' perspective. The qualitative analysis will be interpreted utilizing the Socioecological Model (SEM). The REPORT statement will be followed during analysis and writing of the study. For the qualitative component we aim to report the results in accordance with 'Consolidation criteria for reporting qualitative research (COREQ) and 'Standards for reporting qualitative research '(SRQR) guidelines.<h4>Results</h4>The findings (quantitative and qualitative) will be triangulated to design an evidence-based health literacy framework which can be utilized for service design and re-design to deliver optimal patient centered primary health care services within the country & modelled in similar health care settings geographically.<h4>Discussion</h4>Evidence generated from the study can increase health literacy levels among service users by modification of health behavior through effective health education. Moreover, increased health literacy levels and improved self-care can lead to improved compliance with treatment leading to effective management of diseases, particularly long-term chronic diseases which are associated with multi-morbidity, polypharmacy and challenges associated side effects of prescribed medications.

Medicine, Science
DOAJ Open Access 2025
A novel network-level fused deep learning architecture with shallow neural network classifier for gastrointestinal cancer classification from wireless capsule endoscopy images

Muhammad Attique Khan, Usama Shafiq, Ameer Hamza et al.

Abstract Deep learning has significantly contributed to medical imaging and computer-aided diagnosis (CAD), providing accurate disease classification and diagnosis. However, challenges such as inter- and intra-class similarities, class imbalance, and computational inefficiencies due to numerous hyperparameters persist. This study aims to address these challenges by presenting a novel deep-learning framework for classifying and localizing gastrointestinal (GI) diseases from wireless capsule endoscopy (WCE) images. The proposed framework begins with dataset augmentation to enhance training robustness. Two novel architectures, Sparse Convolutional DenseNet201 with Self-Attention (SC-DSAN) and CNN-GRU, are fused at the network level using a depth concatenation layer, avoiding the computational costs of feature-level fusion. Bayesian Optimization (BO) is employed for dynamic hyperparameter tuning, and an Entropy-controlled Marine Predators Algorithm (EMPA) selects optimal features. These features are classified using a Shallow Wide Neural Network (SWNN) and traditional classifiers. Experimental evaluations on the Kvasir-V1 and Kvasir-V2 datasets demonstrate superior performance, achieving accuracies of 99.60% and 95.10%, respectively. The proposed framework offers improved accuracy, precision, and computational efficiency compared to state-of-the-art models. The proposed framework addresses key challenges in GI disease diagnosis, demonstrating its potential for accurate and efficient clinical applications. Future work will explore its adaptability to additional datasets and optimize its computational complexity for broader deployment.

Computer applications to medicine. Medical informatics
DOAJ Open Access 2022
Cumulative Exposure to High γ-Glutamyl Transferase Level and Risk of Diabetes: A Nationwide Population-Based Study

Ji-Yeon Park, Kyungdo Han, Hun-Sung Kim et al.

Background Elevated γ-glutamyl transferase (γ-GTP) level is associated with metabolic syndrome, impaired glucose tolerance, and insulin resistance, which are risk factors for type 2 diabetes. We aimed to investigate the association of cumulative exposure to high γ-GTP level with risk of diabetes. Methods Using nationally representative data from the Korean National Health Insurance system, 346,206 people who were free of diabetes and who underwent 5 consecutive health examinations from 2005 to 2009 were followed to the end of 2018. High γ-GTP level was defined as those in the highest quartile, and the number of exposures to high γ-GTP level ranged from 0 to 5. Hazard ratio (HR) and 95% confidence interval (CI) for diabetes were analyzed using the multivariable Cox proportional-hazards model. Results The mean follow-up duration was 9.2±1.0 years, during which 15,183 (4.4%) patients developed diabetes. There was a linear increase in the incidence rate and the risk of diabetes with cumulative exposure to high γ-GTP level. After adjusting for possible confounders, the HR of diabetes in subjects with five consecutive high γ-GTP levels were 2.60 (95% CI, 2.47 to 2.73) in men and 3.05 (95% CI, 2.73 to 3.41) in women compared with those who never had a high γ-GTP level. Similar results were observed in various subgroup and sensitivity analyses. Conclusion There was a linear relationship between cumulative exposure to high γ-GTP level and risk of diabetes. Monitoring and lowering γ-GTP level should be considered for prevention of diabetes in the general population.

Diseases of the endocrine glands. Clinical endocrinology
DOAJ Open Access 2022
Efektivitas gel ekstrak jahe gajah (Zingiber officinale var rosc) terhadap kecepatan kesembuhan luka abrasi pada tikus putih (Rattus novergicus) jantan strain wistar

erwien isparnadi, Fatah Jati Pamungkas, Diah Hermayanti et al.

Abstract. Background: Abrasion wound is the release of the skin surface caused by friction with rough surface, ginger anti-inflammatory compound so that it can accelerate the healing of abrasion wounds. Objective: the effectiveness of healing abrasion wounds with gel application of ginger extract (Zingiber Officlinale Var Rosc) on white rats (Rattus norvegicus). Method:  True experimental with post test only control group design. The study was conducted for 7 days with samples divided into 4 groups, P1 (NaCl 0.9%), P2 (Gel 0%), P3 (Ginger Gel 8%), P4 (Ginger Gel 12%). Application of extract gel was done on days 1, 3 and 5. Wound area observed on day 7. Data analyzed using the One Way ANOVA test. Results: The results showed abrasion wound area day 7 at P1 = 1.47 cm2, P2 = 0.58 cm2, P3 = 0.31 cm2, P4 = 0 cm2, healing speed P1 = 4.9% / day, P2 = 10.6% / day, P3 = 12.31% / day, P4 = 14.2% / day. One way ANOVA test results showed a significant effect (p 0.05). Conclusion: Elephant ginger extract extract (Zingiber officinale var rosc) can accelerate healing of abrasion wounds in white rats (Rattus norvegicus).

Medicine (General)
DOAJ Open Access 2022
Supported employment for people with severe mental illness: a pilot study of an Italian social enterprise with a special ingredient

Alessandra Martinelli, Chiara Bonetto, Federica Bonora et al.

Abstract Background People with mental disorders are far more likely to be unemployed than the general population. Two internationally recognized, evidence-based models of interventions for employment for people with severe mental health problems are Individual Placement Support and the Clubhouse. In Italy, a common model is the ‘social enterprise’ (SE), which is a programme run by non-profit organisations that help individuals with disabilities to be employed. Despite SEs spread and relevance in Italy, there are no studies about Italian samples. This paper reports on a pilot evaluation of psychosocial and work outcomes of a SE based in Verona, Italy. The study aims to investigate if people with SMI involved in SE job placements may achieve personal recovery and better outcomes over time, and in comparison with a comparable group of users. Methods This is a pilot descriptive study with three components. A longitudinal design that comprised a functioning description of 33 SE members with a psychiatric disability in two time-points (when they joined the SE—on average 5 years before the study recruitment, and at the study recruitment—year 2018); and a repeated collection of job details of the 33 members in three time points: 2 years before the recruitment,—year 2016; 1 year before the recruitment – year 2017; and at the recruitment—year 2018. An assessment at the recruitment time—year 2018, of SE users’ satisfaction with the job placement, symptoms, functioning, and quality of life (QoL). A cross-sectional study that compared the 33 SE members at the recruitment time—year 2018, with a matched group of people with the following criteria: living in local supported accommodations, being unemployed and not SE members. The two groups were compared on ratings of psychopathology, functioning, and QoL. Descriptive analyses were done. Results At the recruitment time – year 2018, all SE participants showed a significant better functioning (p < 0.001) than when they joined the SE—when they had been employed for an average of 5 years. In comparison to the matched group, SE members had significantly better functioning (p = 0.001), psychopathology (p = 0.007), and QoL (p = 0.034). According to their SE membership status, participants comprised trainees (21.2%) and employee members (78.8%). Trainees compared to employees had lower autonomies, functioning, QoL and more severe psychopathology. Over the two years prior to study recruitment, trainees showed stable poor autonomies, while employee members showed a variation from average autonomies in the 2 years before the recruitment time – year 2016, to good ones at the recruitment time – year 2018. Over the two years, all SE members set increasing numbers of objectives in all three domains. All SE participants reported high levels of satisfaction with all aspects of the job placement. Conclusions SE that provides tailored support to assist people to gain employment skills may be an effective component in helping recovery from SMI.

DOAJ Open Access 2021
DIAGNOSTIC ACCURACY OF MODIFIED EARLY OBSTETRIC WARNING SYSTEM FOR PREDICTION OF MATERNAL MORBIDITY

Sadaf Zohra, Uzma Urooj, Nayla Khalid et al.

Objective: To determine the diagnostic accuracy of modified early obstetric warning system for predicting maternal morbidity keeping ICU admission as “gold standard”. Study Design: Cross sectional validation study. Place and Duration of Study: Department of Obstetrics and Gynecology, Pak Emirates Military Hospital, Rawalpindi, from Oct 2018 to Apr 2019. Methodology: A total of 205 patients of singleton pregnancy, post-natal period <6 weeks, history of hypertension and diabetes were considered in the study. Women were followed up to 6 weeks for maternal morbidity in term of intensive care admission. All the data regarding findings of Modified early obstetric warning system and intensive care admission was noted. Results: The age range of patients was 18-40 years with mean age of 31.585 ± 3.31 years, mean gestational age was 37.595 ± 1.84 weeks and mean parity was 1.839 ± 1.59. Modified early obstetrics warning system as shown sensitivity of 84.38%, specificity 97.11%, diagnostic accuracy by 95%, positive predictive value of 84.38%, negative predictive value of 97.11%, (p=0.001) for prediction of maternal morbidity. Conclusion: Modified early obstetrics warning system chart fulfills most of criteria of ideal screening tool making it a significant bedside screening tool which can predict obstetric morbidity and mortality in pregnant patients.

Medicine, Medicine (General)
DOAJ Open Access 2020
The Effects of Anesthesia on Adult Hippocampal Neurogenesis

Jenny L. Kim, Nicholas E. Bulthuis, Heather A. Cameron

In animal studies, prolonged sedation with general anesthetics has resulted in cognitive impairments that can last for days to weeks after exposure. One mechanism by which anesthesia may impair cognition is by decreasing adult hippocampal neurogenesis. Several studies have seen a reduction in cell survival after anesthesia in rodents with most studies focusing on two particularly vulnerable age windows: the neonatal period and old age. However, the extent to which sedation affects neurogenesis in young adults remains unclear. Adult neurogenesis in the dentate gyrus (DG) was analyzed in male and female rats 24 h after a 4-h period of sedation with isoflurane, propofol, midazolam, or dexmedetomidine. Three different cell populations were quantified: cells that were 1 week or 1 month old, labeled with the permanent birthdate markers EdU or BrdU, respectively, and precursor cells, identified by their expression of the endogenous dividing cell marker proliferating cell nuclear antigen (PCNA) at the time of sacrifice. Midazolam and dexmedetomidine reduced cell proliferation in the adult DG in both sexes but had no effect on postmitotic cells. Propofol reduced the number of relatively mature, 28-day old, neurons specifically in female rats and had no effects on younger cells. Isoflurane had no detectable effects on any of the cell populations examined. These findings show no general effect of sedation on adult-born neurons but demonstrate that certain sedatives do have drug-specific and sex-specific effects. The impacts observed on different cell populations predict that any cognitive effects of these sedatives would likely occur at different times, with propofol producing a rapid but short-lived impairment and midazolam and dexmedetomidine altering cognition after a several week delay. Taken together, these studies lend support to the hypothesis that decreased neurogenesis in the young adult DG may mediate the effects of sedation on cognitive function.

Neurosciences. Biological psychiatry. Neuropsychiatry
DOAJ Open Access 2020
Scalp expansion for giant cutis verticis gyrata secondary to cerebriform intradermal nevus

Wenfang Dong, Huan Wang, Fei Fan

Cutis verticis gyrata (CVG) is characterized by extensive formation of scalp skin that mirrors the folds of the cerebral gyri. Giant CVG secondary to cerebriform intradermal nevus (CIN) has been rarely reported, and its management mainly involves surgical excision. In certain cases of giant CVG, however, surgical excision is dilemmatic. This case report describes a giant CVG secondary to CIN that was successfully managed with scalp expansion and surgical excision. Previously published studies are also reviewed.

Medicine (General)
DOAJ Open Access 2019
Herbal Products and Supplements in Palliative Care

Burcak Deniz Dedeoglu

Conventional medicine focuses mostly on the diagnosis and treatment of disease which is the acute localized problem in healthy body. On the other hand, chronic diseases are functional disorders in physiological processes. Therapeutic goal is not to treat the disease but heal the whole unhealthy body. The environment, changed with the industrial development, created a new human model, that suffering from stress and biologic damage. And that brought us a new terminology; epigenetics. Today, we are aware of that; the body would help itself for healing if we support. Up to date oncology approach, immuno-oncology is the study and development of treatments that take advantage of the body&#8217;s immune system to fight cancer. Nature is the main source to support immune system. There is not enough reliable scientific evidence to use it as a treatment for cancer. Bu it is already a part of supportive and palliative care. Supportive treatment is not secondary to cancer. Scientific studies have shown that humans and other organisms are able to adapt better and survive longer when using these adaptogenic herbs. Treating chemo side effects naturally is a common practice these days and it is supported by strong scientific evidence.

General Works
DOAJ Open Access 2019
TRATAMIENTO QUIRÚRGICO DE LA COLITIS ULCEROSA

Udo Kronberg

Resumen: El tratamiento médico de pacientes con colitis ulcerosa se basa en aminosalicilatos, corticoides, inmunomoduladores y en los últimos años en terapia biológica predominantemente con anti-TNF. La falla de este tratamiento, efectos adversos de los fármacos o complicaciones de la enfermedad, incluyendo el desarrollo de neoplasias, pueden llevar al paciente a requerir un tratamiento quirúrgico. Este procedimiento, habitualmente en etapas, consiste en la extirpación de colon y recto. En caso de urgencia, se procede inicialmente a la colectomía subtotal con ileostomía, para luego resecar el recto en forma electiva. Para evitar una ileostomía definitiva, el procedimiento de elección es la reconstitución del tránsito intestinal con reservorio ileal. En centros especializados, esta operación de alta complejidad se puede realizar con tasas de complicaciones razonables y con una baja mortalidad. La calidad de vida de los pacientes operados es en general adecuada, y la gran mayoría volvería a someterse al procedimiento si tuviera que elegir nuevamente. Abstract: Medical treatment of ulcerative colitis is based on aminosalicylates, corticosteroids, immunomodulators and lately biological therapy mainly with anti-TNF antibodies. Failure of these treatments, adverse effects of the medication, or disease-related complications including neoplasia may take the patient to require a surgical treatment which consists in a complete removal of colon and rectum, most frequently in a staged fashion. In urgent cases, subtotal colectomy with end ileostomy is performed, followed by an elective proctectomy later on. In order to avoid a permanent ileostomy, restorative surgery with an ileoanal pouch anastomosis (IPAA) is the procedure of choice. In specialized centers, this complex operation can be performed safely with an adequate complication rate and low mortality. Overall quality of life of patients with IPAA is adequate, and the vast majority of patients would undergo surgery again if they had to choose a second time. Palabras clave: Colitis ulcerosa, Proctocolectomía restaurativa, Reservorio ileal, Calidad de vida, Keywords: Ulcerative colitis, Restorative total proctocolectomy, Ileoanal pouch, Quality of life

DOAJ Open Access 2018
Routine MRCP in the management of patients with gallbladder stones awaiting cholecystectomy: a single-centre experience

Valentina Virzì, Noemi Maria Giovanna Ognibene, Antonio Salvatore Sciortino et al.

Abstract Objectives To assess the frequency of choledocolithiasis and the role of preoperative laboratory findings, ultrasound (US) and magnetic resonance cholangio-pancreatography (MRCP) in the detection of choledocolithiasis in patients with gallbladder stones awaiting cholecystectomy. Methods A consecutive sample of 104 patients underwent MRCP prior to cholecystectomy. The patients were classified into different groups on the basis of the risk of choledocolithiasis. A specialised doctor with more 10 years of experience performed the US interpretation and a radiologist performed the MRCP interpretation blinded to US or aspartate aminotransferase (AST)/alanine aminotransferase (ALT)/alkaline phosphatase (ALP) results. A chi-square (χ2) test was performed to assess the statistical significance of differences in the frequency of choledocolithiasis based on laboratory findings, choledocal diameter on US and group risk. Results MRCP showed calculi in 7 out of 104 patients (6.7%), with no statistically significant differences between the high/moderate risk and low/no risk groups and between the patients with normal and altered laboratory findings or choledocal diameter on preoperative US. The sensitivity and specificity of AST/ALT [positive predictive value (PPV): 12%; negative predictive value (NPV): 94%], ALP (PPV: 7%; NPV: 94%), total serum bilirubin (PPV: 6%; NPV: 93%) and choledocal diameter (PPV: 20%; NPV: 94%) were, respectively, 28.6 and 94.8%, 85.7 and 17.5%, 14.3 and 93.8%, and 14.3 and 95.9%. Conclusions MRCP is a reliable evaluation for the detection of common bile duct (CBD) stones, reducing the misdiagnosis of retained choledocholithiasis with normal biochemical predictors and US examination. Main messages • MRCP is a non-invasive method for the detection of CBD stones. • Preoperative MRCP reduces the misdiagnosis of retained choledocholithiasis. • Detection of choledocholithiasis is mandatory prior to cholecystectomy to avoid surgical morbidity

Medical physics. Medical radiology. Nuclear medicine
DOAJ Open Access 2017
Predictive model for 5-year mortality after breast cancer surgery in Taiwan residents

Su-Hsin Huang, Joon-Khim Loh, Jinn-Tsong Tsai et al.

Abstract Background Few studies of breast cancer surgery outcomes have used longitudinal data for more than 2 years. This study aimed to validate the use of the artificial neural network (ANN) model to predict the 5-year mortality of breast cancer patients after surgery and compare predictive accuracy between the ANN model, multiple logistic regression (MLR) model, and Cox regression model. Methods This study compared the MLR, Cox, and ANN models based on clinical data of 3632 breast cancer patients who underwent surgery between 1996 and 2010. An estimation dataset was used to train the model, and a validation dataset was used to evaluate model performance. The sensitivity analysis was also used to assess the relative significance of input variables in the prediction model. Results The ANN model significantly outperformed the MLR and Cox models in predicting 5-year mortality, with higher overall performance indices. The results indicated that the 5-year postoperative mortality of breast cancer patients was significantly associated with age, Charlson comorbidity index (CCI), chemotherapy, radiotherapy, hormone therapy, and breast cancer surgery volumes of hospital and surgeon (all P < 0.05). Breast cancer surgery volume of surgeon was the most influential (sensitive) variable affecting 5-year mortality, followed by breast cancer surgery volume of hospital, age, and CCI. Conclusions Compared with the conventional MLR and Cox models, the ANN model was more accurate in predicting 5-year mortality of breast cancer patients who underwent surgery. The mortality predictors identified in this study can also be used to educate candidates for breast cancer surgery with respect to the course of recovery and health outcomes.

Neoplasms. Tumors. Oncology. Including cancer and carcinogens
DOAJ Open Access 2017
Cost effectiveness of vildagliptin versus glimepiride as add-on treatment to metformin for the treatment of diabetes mellitus type 2 patients in Greece

Hara Kousoulakou, Magdalini Hatzikou, Varvara Baroutsou et al.

Abstract Objectives This study was designed to assess the cost-effectiveness of vildagliptin versus glimepiride as add-on to metformin in the management of type 2 diabetes mellitus (T2DM) patients in the Greek healthcare setting. Methods A cost-effectiveness model was designed, using MS Excel, to compare two treatment strategies. Strategy 1 consisted of first-line metformin, followed by metformin + vildagliptin in second-line, while strategy 2 consisted of first line metformin, followed by metformin + glimepiride in second line. Subsequent lines were the same in both strategies and consisted of metformin + basal insulin and metformin + basal + rapid insulin. Clinical data and utility decrements relating to diabetes complications were taken from the published literature. Only direct medical costs were included in the analysis (cost base year 2014), and consisted of drug, adverse events and comorbidity costs (taken from local officially published sources and the literature). The perspective adopted was that of the Social Insurance Fund. The time horizon was lifetime, and future costs and outcomes were discounted at 3.5% per annum. Results Adding vildagliptin to metformin increased drug costs compared with adding glimepiride to metformin (€2853 vs. €2427, respectively). However, this increase was offset by a decrease in the costs of associated comorbidities (€4393 vs. €4539) and adverse events (€2757 vs. €3111), resulting in a lower total cost of €74 in strategy 1 compared with strategy 2. Comorbidities were the largest cost component in both strategies, accounting for 43.9 and 45.0% in strategies 1 and 2, respectively. Strategy 1 was also associated with increased life-years (LYs, 0.11) and quality-adjusted life-years (QALYs, 0.11) compared with strategy 2. Strategy 1 is therefore dominant, as it is associated with both lower overall costs and increased effectiveness. Conclusions Vildagliptin as add-on treatment to metformin in the management of T2DM in Greece appears to be dominant versus. glimepiride in terms of both cost per LY and cost per QALY gained.

Medicine (General)
DOAJ Open Access 2014
Formulation, evaluation and comparison of the herbal shampoo with the commercial shampoos

Khaloud Al Badi, Shah A. Khan

The study aimed to formulate a pure herbal shampoo and to evaluate and compare its physicochemical properties with the marketed synthetic and herbal shampoos. The herbal shampoo was formulated by adding the extracts of Acacia concinna, Sapindus mukorossi, Phyllanthus emblica, Ziziphus spina-christi and Citrus aurantifolia in different proportions to a 10% aqueous gelatin solution. Small amount of methyl paraben was added as a preservative and pH was adjusted with citric acid. Several tests such as visual inspection, pH, wetting time, % of solid contents, foam volume and stability, surface tension, detergency, dirt dispersion etc, were performed to determine the physicochemical properties of both prepared and marketed shampoos. The formulated herbal shampoo was also evaluated for conditioning performance by administering a blind test to 20 student volunteers. The formulated herbal shampoo was clear and appealing. It showed good cleansing and detergency, low surface tension, small bubble size and good foam stability after 5 min. The prepared shampoo and commercial shampoos showed comparable results for % solid contents also. The score of the conditioning performance of the tress washed with herbal shampoo was found to be 3.0 out of 4, while the score of the marketed synthetic and herbal shampoo was 3.4 and 3.3 respectively. The results indicated the formulated shampoo is having excellent conditioning performance, at par with commercially available shampoo. However, further research and development is required to improve it's quality and safety.

Medicine (General), Science
DOAJ Open Access 2013
Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review

Razavi Seyed Mansour, Ghanei Mostafa, Salamati Payman et al.

【Abstract】To review long-term respiratory effects of mustard gas on Iranian veterans having undergone Iraq-Iran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion. The main pathogenic factors are free radical mediators. Preva-lence of pulmonary involvement is approximately 42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmo-nary disease, bronchiectasis, and asthma. Spirometry re-sults can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mus-tard lung. The effective treatment regimens consist of oxy-gen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, thera-peutic bronchoscopy, laser therapy, placement of respira-tory stents, early tracheostomy in laryngospasm, and ulti-mately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement). There are various treatment protocols, but unfortunately none of them is definitely curable. Key words: Lung injury; Chemical warfare; Mustard gas

Medicine (General)
DOAJ Open Access 2013
The Architecture of an Automatic eHealth Platform With Mobile Client for Cerebrovascular Disease Detection

Wang, Xingce, Bie, Rongfang, Sun, Yunchuan et al.

BackgroundIn recent years, cerebrovascular disease has been the leading cause of death and adult disability in the world. This study describes an efficient approach to detect cerebrovascular disease. ObjectiveIn order to improve cerebrovascular treatment, prevention, and care, an automatic cerebrovascular disease detection eHealth platform is designed and studied. MethodsWe designed an automatic eHealth platform for cerebrovascular disease detection with a four-level architecture: object control layer, data transmission layer, service supporting layer, and application service layer. The platform has eight main functions: cerebrovascular database management, preprocessing of cerebral image data, image viewing and adjustment model, image cropping compression and measurement, cerebrovascular segmentation, 3-dimensional cerebrovascular reconstruction, cerebrovascular rendering, cerebrovascular virtual endoscope, and automatic detection. Several key technologies were employed for the implementation of the platform. The anisotropic diffusion model was used to reduce the noise. Statistics segmentation with Gaussian-Markov random field model (G-MRF) and Stochastic Estimation Maximization (SEM) parameter estimation method were used to realize the cerebrovascular segmentation. Ball B-Spline curve was proposed to model the cerebral blood vessels. Compute unified device architecture (CUDA) based on ray-casting volume rendering presented by curvature enhancement and boundary enhancement were used to realize the volume rendering model. We implemented the platform with a network client and mobile phone client to fit different users. ResultsThe implemented platform is running on a common personal computer. Experiments on 32 patients’ brain computed tomography data or brain magnetic resonance imaging data stored in the system verified the feasibility and validity of each model we proposed. The platform is partly used in the cranial nerve surgery of the First Hospital Affiliated to the General Hospital of People's Liberation Army and radiology of Beijing Navy General Hospital. At the same time it also gets some applications in medical imaging specialty teaching of Tianjin Medical University. The application results have also been validated by our neurosurgeon and radiologist. ConclusionsThe platform appears beneficial in diagnosis of the cerebrovascular disease. The long-term benefits and additional applications of this technology warrant further study. The research built a diagnosis and treatment platform of the human tissue with complex geometry and topology such as brain vessel based on the Internet of things.

Information technology, Public aspects of medicine

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