Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Digital Health”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed2000

Digital imaging analysis for the study of endotoxin-induced mitochondrial ultrastructure injury.

Primary defects in mitochondrial function have been implicated in over 100 diverse diseases. In situ, mitochondria possess unique and well-defined morphology in normal healthy cells, but diseases linked to defective mitochondrial function are characterized by the presence of morphologically abnormal and swollen mitochondria with distorted cristae. In situ study of mitochondrial morphology is established as an indicator of mitochondrial health but thus far assessments have been via subjective evaluations by trained observers using discontinuous scoring systems. Here we investigated the value of digital imaging analysis to provide for unbiased, reproducible, and convenient evaluations of mitochondrial ultrastructure. Electron photomicrographs of ileal mucosal mitochondria were investigated using a scoring system previously described by us, and also analyzed digitally by using six digital parameters which define size, shape, and electron density characteristics of over 700 individual mitochondria. Statistically significant changes in mitochondrial morphology were detected in LPS treated animals relative to vehicle control using both the subjective scoring system and digital imaging parameters (p < 0.05). However, the imaging approach provided convenient and high throughput capabilities and was easily automated to remove investigator influences. These results illustrate significant changes in ileal mucosal mitochondrial ultrastructure during sepsis and demonstrate the value of digital imaging technology for routine assessments in this setting.

Analog-Digital Conversion↗
PubMed1983

Epitrochlear node involvement in melanoma of the upper extremity.

Between 1955 and 1979, 240 patients with melanoma of the upper extremity were admitted to the National Institutes of Health (NIH). Thirty nine of these patients (16%) had primary lesions of the forearm, hand, or digit. Twenty-two patients underwent axillary dissection during their treatment. Ten patients were subjected to both axillary and epitrochlear lymph node dissection. Nine of these ten patients had lymph node metastases; two in the axillary nodes only, two in the epitrochlear nodes only, and five in both nodal groups. Epitrochlear node involvement occurred in 18% of patients with forearm or hand lesions, and only when the primary melanoma was within 5 cm of the elbow or in the ulnar distribution, the classically described drainage area of the epitrochlear nodes. The prognosis of the patients in this study was related to the depth of their primary lesions and the presence or absence of axillary node involvement. However, since approximately 18% of patients with melanomas of the hand, forearm and elbow area have a high probability of recurrence in the epitrochlear nodes, close attention to this area and early dissection of clinically suspicious nodes can favorably affect locoregional control in this group of melanoma patients.

Adult↗
PubMed2004

Variable sac behavior after endovascular repair of abdominal aortic aneurysm: analysis of core laboratory data.

OBJECTIVES: The behavior of the aneurysm sac after endovascular grafting has been the subject of significant speculation. The importance of sac behavior is manifested by the correlation between aneurysm size or size change and risk for rupture, and potentially further extrapolated to define the need for secondary intervention. This study was undertaken to define graft-specific differences and the effect of endoleak on sac remodeling. METHODS: Core laboratory data were obtained for three US Phase II clinical trials. Patients were included if they met anatomic inclusion criteria and underwent placement of the latest version of a bifurcated endovascular prosthesis. Unsupported Dacron (Ancure), supported Dacron (Zenith), and expanded polytetrafluoroethylene (Excluder) grafts were evaluated. Digitized images were electronically assessed for aneurysm size (area, maximum, minimum diameter) with National Institutes of Health Image software. Two blinded reviewers analyzed each radiographic study to ensure accurate image selection and establish the presence or absence of endoleak. A third reviewer adjudicated discrepancies. chi(2) analysis and mixed nonlinear modeling were used to analyze the results. RESULTS: Of 1506 patients evaluated, 723 (227 Ancure, 343 Excluder, 153 Zenith) met inclusion criteria for the study. Mean follow-up was 23.2 months (Ancure, 31.3 months; Excluder, 19.6 months; Zenith, 19.3 months). The incidence of any endoleak was 39.1% (Ancure, 58.1%; Excluder, 34.7%; Zenith, 20.9%; P <.001). Type of prosthesis, presence or absence of endoleak, and baseline size were determinants of rate of aneurysm shrinkage. Reduction in sac size was greatest with the Zenith graft, followed by the Ancure and Excluder grafts. Presence of endoleak had a moderating effect on rate of sac shrinkage with the Zenith and Ancure grafts; however, sac size increased in the presence of endoleak with the Excluder graft. Finally, baseline size was positively correlated with rate of aneurysm shrinkage. CONCLUSIONS: The behavior of the aneurysm sac depends on the type of prosthesis, presence or absence of endoleak, and baseline size of the sac. Differential sac behavior must be considered when determining the need for secondary interventions, timing follow-up studies, and assessing success or failure of endovascular repair.

Aorta, Abdominal↗
PubMed2003

A cost study of new media supported near oral anticoagulant treatment follow-up.

OBJECTIVE: In this study we sought to develop a comparative cost evaluation between conventional and new media, e.g. web, mobile communication technology and digital television, and near patient testing supported anticoagulant (ac) treatment follow-up in a primary health care setting. METHOD: The comparison was done for two patient groups, self-care and home-care patients, on oral ac treatment in the primary health care centre of the rural and sparsely populated municipality of Ikaalinen. In practise case analysis was used to develop cost functions from collected economic data, which were analysed to determine the break-even point in total cost between conventional and new media supported follow-up for the two patient groups. RESULTS: In the home-care setting the break-even point is 14 patients; in the self-care setting new media supported follow-up is always more cost-effective. CONCLUSION: The results illustrate that the use of new media and near patient testing in ac treatment follow-up brings about an economic benefit even with a small number of patients in the Ikaalinen setting. However, the sensitivity of break-even to perturbations in the individual costs of the used economic models remains high. Still, when the economic benefits are considered together with the clinical and practical benefits shown to result from self-testing, self-management and use of new media technologies the new service models can be said to provide noticeable benefits both in terms of quality of care and economics in our specific setting.

Administration, Oral↗
PubMed2004

An Intranet-based clinical imaging service.

This paper explains how the Photographic Department at The Queen Victoria Hospital, East Grinstead, has transformed its clinical photography service through the use of digital technology. The Department now plays a more proactive role in patient care, and its intranet-based digital imaging system has been recognized as an area of best practice by The Department of Health Information Policy Unit and by the Medicines and Healthcare Products Regulatory Agency.

Humans↗
PubMedDate not supplied

Age-related slowing on the Digit Symbol task: longitudinal and cross-sectional analyses.

It is generally known that slowing on tasks like the Digit Symbol Substitution task occurs with age. However, simultaneous cross-sectional and longitudinal data are rare. The results from the cross-sectional analysis of Digit Symbol performance with age are compared to results from two occasion longitudinal analyses on the same task. The longitudinal data were obtained from 79 participants who were retested after 7 years and were between the ages of 48 and 73 years old at Time 1. Results indicated that the pattern of actual change observed in the longitudinal analyses replicated the simulated change indicated in the cross-sectional analysis. Antecedents were examined using the original cross-sectional sample of 150 participants. Significant relationships with Digit Symbol performance were found for age, education, and gender, but not for ratings of physical health.

Aged↗
PubMed2005

Socially unbiased parenting support on the Internet: a cross-sectional study of users of a large Swedish parenting website.

BACKGROUND: The Internet is becoming increasingly recognized as a source of social support. Parents of children with cancer and autism have been shown to find social support online, and many parents of healthy infants and children seek information about parenting online. However, access and use of the Internet is greater among socio-economically advantaged groups, a phenomenon known as the 'digital divide'. Our aim was to investigate whether users of a Swedish general parenting website perceived support in the parenting role and, if so, whether this support was socially biased because of the digital divide phenomenon. METHODS: Users of the largest Swedish parenting website were asked to participate in the study. A total of 2221 users completed the anonymous survey posted on the website during a one-week period. RESULTS: Most respondents (95%) were female (mean age 30.6 years). Respondents' educational level was slightly, but not significantly, higher than that in the general population, whereas 68% had income levels at or under the national average, contradicting the intuitive hypothesis that users would be socio-economically privileged. Perceived social support, measured by the Interpersonal Support Evaluation List (ISEL) appraisal subscale, indicated high perceived support. Living without a partner and having lower levels of income and education increased perceived support. The perception that other parents' opinions are more valuable than the advice of experts was influential in the regression equation for ISEL scores, indicating that peer help is important in online social support. CONCLUSIONS: Internet use for general parenting issues in Sweden, mainly by women, does not seem to follow the digital divide phenomenon. Therefore, the internet provides an exciting opportunity for future infant and child public health work. The lack of fathers, however, was a surprising finding and introduces a gender bias into this seemingly socially unbiased medium.

Adolescent↗
PubMed2001

Radiographic defect depth and width for prognosis and description of periodontal healing of infrabony defects.

BACKGROUND: The aims of the present study were to evaluate 1) defect depth and width as a prognostic factor and 2) change in defect width as a describing parameter of periodontal healing in infrabony defects treated by regenerative therapy after 6 and 24 months. METHODS: In 24 patients with advanced periodontitis, 39 infrabony defects were treated by guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (ePTFE) (n = 7) or bioabsorbable barriers (n = 32). Clinical parameters were assessed and 39 standardized radiographs (in triplicate) were taken before and 6 and 24 months after surgery. Using a computer-assisted analysis, the depth, width, and angle of the bony defects were measured. RESULTS: Statistically significant vertical clinical attachment gains (CAL-V: 3.15 +/- 1.63 mm to 3.31 +/- 1.65 mm; P<0.001) and bony fill (1.30 +/- 2.53 mm; P<0.01 to 1.54 +/- 2.70 mm; P<0.005) were observed 6 and 24 months postsurgically. In a multilevel regression analysis CAL-V gain was predicted by baseline CAL-V (P <0.0001), actual smoking (P <0.05), and age (P <0.1). Bony fill could be predicted by baseline height of the infrabony component (P<0.0001), gingival index at baseline (P<0.05), and actual smoking (P <0.01). In narrow (<26 degrees) and deep (> or = 3 mm) infrabony defects bony fill was more pronounced than in wide and shallow defects (P <0.05). CONCLUSIONS: Improvement achieved by guided tissue regeneration in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and to some extent clinically more favorably to GTR therapy than wide and shallow defects. However, depth of the infrabony component was a stronger prognostic parameter than defect angle. Actual smoking impairs the results of GTR therapy in infrabony defects.

Adult↗
PubMed1995

Will paper ever go away? Document imagers bet it won't.

Health care providers and payers alike would like to eliminate their paperwork, converting all information to digital form. Many provider organizations are attempting to implement computerized patient record systems designed to eventually eliminate the traditional file folders crammed with paper records. And a widespread movement to electronic data interchange for financial transactions holds out hope of eliminating paper claims and related financial transactions. But moving from a paper-intensive world to a computer world takes time, and the transition will never be complete.

Attitude to Computers↗
PubMed2003

Issues in using databases of pre-recorded physiological signals to test medical devices.

Bench testing with databases of pre-recorded physiological signals is a common step in the verification and validation of medical devices. For example, in the case of an electrocardiographic (ECG) monitor to be tested, the physiological signals are ECG tracings that have previously been recorded from patients using other ECG monitors. Human overreaders then annotate the tracings to determine the occurrence of significant clinical events such as ventricular tachycardia. These annotations can be used to determine the sensitivity and specificity of the ECG monitor to be tested. This article aims to highlight some issues associated with such bench testing, such as the way the pre-recorded signals are presented to the medical device to be tested, the adequacy of single channel versus dual channel versus multi-channel testing in the bench testing, and the need for the human overreaders and the medical device to use the same set of rules for determining the occurrence of a clinical event. These issues are also applicable to other monitors such as the apnea monitor. Some suggestions for addressing the issues are presented.

Analog-Digital Conversion↗
PubMed1993

[Quality criteria of DSA in neurologic problems].

The further development of quality assurance in radiology requires also criteria for more complex examinations like digital subtraction angiography (DSA). The physical condition of the patient and his cooperation, the knowledge and experience of the physician, as well as the technical parameters of the DSA-unit, and the technique of examination determine the quality of any angiography. Aspects of these factors are discussed. It is found that, especially for neuroradiologic studies, the complex problem of quality can only be solved in part by measurable parameters. Only the performance of the DSA-system can be defined by measurements. Other factors defining quality cannot be measured at least to the same degree. The most relevant criteria of quality, however, are: have there been complications and can the clinical question be answered adequately by the DSA-study.

Angiography, Digital Subtraction↗
PubMed2006

A pilot study to measure the compressive and tensile forces required to use retractable intramuscular safety syringes.

BACKGROUND: A pilot study was conducted at the Tampa Veterans Administration Patient Safety Center. The objective was to determine the forces required to operate retractable safety syringes to evaluate potential adverse occupational health and patient safety issues. METHODS: Four brands (100 each) of retractable syringes were tested, using a digital force gauge, in air and in a simulated patient material (SPM). Compressive and tensile forces were measured while activating the retraction mechanism and withdrawing saline into the syringe barrel, respectively. RESULTS: The mean compressive force was greater in SPM than in air in all 4 devices. There was a statistically significant compressive force difference between activation in air and SPM in devices 1 and 2 (P </= .05). The tensile forces for all devices were lower than the compressive forces. Analysis of variance was used to compare the groups, and the results showed that the means were significantly different (P < .001). CONCLUSION: This pilot study has implications for device selection, training for users, design issues for manufacturers, and patient safety, as well as potential for future needlestick and ergonomic injuries. We recommend replication of this study with a computer-controlled force testing apparatus, and by testing multiple needle and syringe sizes.

Accidents, Occupational↗
PubMed1998

Beyond the hype. Proven strategies for fixing the year 2000 problem.

Many health care organizations are developing effective strategies for coping with the year 2000 problem, assuring that computers with two-digit date fields will recognize that 00 signifies 2000. Clinics, hospitals and other sites are finding that in addition to fixing their core information systems, they also must carefully analyze the year-recognition capabilities of crucial medical devices--and even elevators.

Chronology as Topic↗
PubMed2005

Health-related quality of life and health risk behaviors among smokers.

BACKGROUND: It is well established that smoking has detrimental effects on physical health, but its associations with health-related quality of life (HRQOL) and a variety of health behaviors have not been widely investigated in the U.S. population. METHODS: Data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, random-digit-dialed telephone survey of non-institutionalized persons aged > or =18 years in the United States, Guam, Puerto Rico, and the Virgin Islands, were used in this investigation. The BRFSS monitors the prevalence of key health- and safety-related behaviors and characteristics. In 2001 and 2002 combined, trained interviewers administered HRQOL questions in 23 states and the District of Columbia (n=82,918). This analysis was conducted in 2004. RESULTS: Overall, an estimated 22.4% of adults were current smokers, 24.1% were former smokers, and 53.6% never smoked. Current smokers had significantly poorer HRQOL than those who had never smoked, and were more likely to drink heavily, to binge drink, and to report depressive and anxiety symptoms. Additionally, current smokers were significantly more likely than those who never smoked to be physically inactive, to report frequent sleep impairment, to report frequent pain, and to eat less than five servings of fruits and vegetables per day. CONCLUSIONS: While there are strong positive relationships between smoking and both alcohol consumption and mood disturbance, smoking is also associated with an array of other modifiable risk factors meriting assessment and intervention. In addition to smoking cessation, the increased morbidity and mortality characterizing smokers may potentially be further reduced by improvements in diet, physical activity, and sleep.

Adolescent↗
PubMed2005

Perceived health status and health-promoting behaviors of African-American and White informal caregivers of impaired elders.

Caregiving and its consequences are major concerns for nurses. Many studies have examined health-promoting behaviors in general (Duffy, 1993; Walker, Volkan, Sechrist, & Pender, 1988), but few studies have explored health-promoting behaviors of caregivers. The purpose of this study was to examine the effects of age, gender, race, and length of caregiving on perceived health status and health-promoting behaviors of African-American and White informal caregivers of impaired elders. Data from a larger study was used to examine a conceptual model linking perceived health status and health-promoting behavior. A sample of 136 (n = 136) African-American and 257 (n = 257) White caregivers was recruited from northeastern Ohio through random digit dialing and interviewed face to face. English-speaking caregivers were selected for study who provided unpaid assistance or care for a minimum of five hours a week to an impaired person 60 years of age or older living in the community. The Health-Promoting Behavior Questionnaire, perceived health status, and a demographic profile were used to measure the study variables. Data were analyzed using hierarchical multiple regression. Findings from this study suggest that the overall fit of the conceptual model was significant, and that moreover, the relationship found between perceived health status and health-promoting behaviors supported Pender's model of health promotion (Pender, 1987). The relationship between perceived health status and health-promoting behaviors has not been documented in prior studies of caregivers, or in studies comparing the two racial groups of African-Americans and Whites.

Adult↗
PubMed2004

Marketing and health libraries.

AIM: To present an overview of the concepts of marketing and to examine ways in which they can be applied to health libraries. METHODS: A review was carried out of literature relating to health libraries using LISA, CINAHL, BNI and Google. RESULTS: Marketing is seen as a strategic management activity aimed at developing customer relationships. Concepts such as the 'four Ps' (product, price, place and promotion), marketing plans, the marketing mix, segmentation, promotion and evaluation are identified and discussed in relation to health libraries. CONCLUSION: In increasingly complex health service and information environments, the marketing and promotion of library services is becoming more important if those services are to justify the resources given to them. Marketing techniques are equally applicable to physical and digital library services.

Advertising↗