Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
Concepts on the pathogenesis of adolescent idiopathic scoliosis. Bone growth and mass, vertebral column, spinal cord, brain, skull, extra-spinal left-right skeletal length asymmetries, disproportions and molecular pathogenesis.
There is no generally accepted scientific theory for the causes of adolescent idiopathic scoliosis (AIS). Encouraging advances thought to be related to AIS pathogenesis have recently been made in several fields including anthropometry of bone growth, bone mass, spinal growth modulation, extra-spinal left-right skeletal length asymmetries and disproportions, magnetic resonance imaging of vertebral column, spinal cord, brain, skull, and molecular pathogenesis. These advances are leading to the evaluation of new treatments including attempts at minimally invasive surgery on the spine and peri-apical ribs. ⋯ From these concepts, a collective model for AIS pathogenesis is formulated. The central concept of this model includes the body schema of the neural systems, widely-studied in adults, that control normal posture and coordinated movements with frames of reference in the posterior parietal cortex. The escalator concept has implications for the normal development of upright posture, and the evolution in humans of neural control, the trunk and unique bipedal gait.
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Cross-border activities in health care in the European single market are increasing. Many of these cross-border developments are related to e-Health. E-Health describes the application of information and communication technologies across the whole range of functions that affect the health care sector. ⋯ More and clear guidelines on the reimbursement criteria for telemedicine and on liability would also be very useful. Guidance at the European level can be given as to the criteria that (tele-) health sessions will have to comply with for reimbursement purposes, since it is still unclear when e-Health sessions will be reimbursed. It is clear that the existing European legal framework is not finished yet and that more specific European rules are needed.
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Stud Health Technol Inform · Jan 2008
Risser sign: the value of the lateral spinal radiograph to assess the excursion of the iliac apophysis.
The course of the ossification of the iliac apophysis is considered in adolescent patients with idiopathic scoliosis, under the name of the Risser sign, to determine the remaining spinal growth. Although the iliac crest develops in the three-dimensional space as a complex structure, the iliac apophysis ossification has been assessed only on a one plane frontal spinal radiograph. This study points out the usefulness of the lateral radiograph for the visualization of the whole iliac crest, especially the posterior region which otherwise cannot be observed. ⋯ The regions of the maximal thickness corresponded to the earliest appearance of the apophysis ossification (Risser 1), while the thin part of the iliac bone corresponded to late appearance of the apophysis ossification (Risser 3-4). The ossification of the posterior part of the crest was best visualized with the lateral radiograph, which was exclusive in showing the posterior superior iliac spine region. On the frontal spinal radiograph the end of the course of the apophysis (Risser 3-4) is usually searched at the level of the sacroiliac joint, while in reality this point was found to be situated more caudal, and accessible for observation on the lateral radiograph.
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Stud Health Technol Inform · Jan 2008
An artificial neural network derived trauma outcome prediction score as an aid to triage for non-clinicians.
In mass casualty events Emergency Medical Service Providers (EMS) choose treatment at Scene or a "scoop and run" approach. The latter requires clinically trained personnel at the reception site to triage patients. Current methodology based on Revised Trauma Score (tRTS) requires use of Glasgow Coma Scale, a method reliant on experience and clinical knowledge. ⋯ Models performed well in predicting mortality compared to standard outcome predictors. Possible additional variables such as gender or ethnicity might improve the Neural Network predictive ability. Pulse appears an essential variable not recorded by the NTDB.
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Stud Health Technol Inform · Jan 2008
Telemedicine for home health and the new patient: when do we really need to go to the hospital?
This chapter will review the current state-of-the-art of home health services in the telemedicine environment. Two aspects in particular will be discussed that reflect where most of the efforts in home telehealth care are being directed. ⋯ In this application, the users may be patients with chronic conditions such as asthma or diabetes that require regular monitoring to achieve or maintain healthy functioning, but they are typically not in an acute phase. More and more often, however, the users of distance monitoring technologies are relatively healthy people looking to enhance their health awareness and healthy status by monitoring various vital signs to alert them of any potential changes in their health status that would require actual medical attention.