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1.
Otol Neurotol ; 43(6): 638-642, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1909021

ABSTRACT

OBJECTIVE: Present results with remote intraoperative neural response telemetry (NRT) during cochlear implantation (CI) and its usefulness in overcoming the inefficiency of in person NRT. STUDY DESIGN: Case series. SETTING: Tertiary academic otology practice. PATIENTS: All patients undergoing primary or revision CI, both adult and pediatric, were enrolled. INTERVENTIONS: Remote intraoperative NRT performed by audiologists using a desktop computer to control a laptop in the operating room. Testing was performed over the hospital network using commercially available software. A single system was used to test all three FDA-approved manufacturers' devices. MAIN OUTCOME MEASURES: Success rate and time savings of remote NRT. RESULTS: Out of 254 procedures, 252 (99.2%) underwent successful remote NRT. In two procedures (0.7%), remote testing was unsuccessful, and required in-person testing to address technical issues.Both failed attempts were due to hardware failure (OR laptop or headpiece problems). There was no relation between success of the procedure and patient/surgical factors such as difficult anatomy, or the approach used for inner ear access. The audiologist time saved using this approach was considerable when compared with in-person testing. CONCLUSIONS: Remote intraoperative NRT testing during cochlear implantation can be performed effectively using standard hardware and remote-control software. Especially important during the Covid-19 pandemic, such a procedure can reduce in-person contacts, and limit the number of individuals in the operating room. Remote testing can provide additional flexibility and efficiency in audiologist schedules.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Adult , Child , Cochlear Implantation/methods , Humans , Pandemics , Telemetry/methods
2.
Eur Rev Med Pharmacol Sci ; 26(5): 1777-1785, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1754188

ABSTRACT

OBJECTIVE: The first pandemic phase of COVID-19 in Italy was characterized by high in-hospital mortality ranging from 23% to 38%. During the third pandemic phase there has been an improvement in the management and treatment of COVID-19, so mortality and predictors may have changed. A prospective study was planned to identify predictors of mortality during the third pandemic phase. PATIENTS AND METHODS: From 15 December 2020 to 15 May 2021, 208 patients were hospitalized (median age: 64 years; males: 58.6%); 83% had a median of 2 (IQR,1-4) comorbidities; pneumonia was present in 89.8%. Patients were monitored remotely for respiratory function and ECG trace for 24 hours/day. Management and treatment were done following the timing and dosage recommended by international guidelines. RESULTS: 79.2% of patients necessitated O2-therapy. ARDS was present in 46.1% of patients and 45.4% received non-invasive ventilation and 11.1% required ICU treatment. 38% developed arrhythmias which were identified early by telemetry and promptly treated. The in-hospital mortality rate was 10%. At multivariate analysis independent predictors of mortality were: older age (R-R for≥70 years: 5.44), number of comorbidities ≥3 (R-R 2.72), eGFR ≤60 ml/min (RR 2.91), high d-Dimer (R-R for≥1,000 ng/ml:7.53), and low PaO2/FiO2 (R-R for <200: 3.21). CONCLUSIONS: Management and treatment adherence to recommendations, use of telemetry, and no overcrowding appear to reduce mortality. Advanced age, number of comorbidities, severe renal failure, high d-Dimer and low P/F remain predictors of poor outcome. The data help to identify current high-risk COVID-19 patients in whom management has yet to be optimized, who require the greatest therapeutic effort, and subjects in whom vaccination is mandatory.


Subject(s)
COVID-19/mortality , Hospital Departments/organization & administration , Hospital Mortality , Internal Medicine/methods , Pandemics , Telemetry/methods , Age Factors , Aged , Critical Care , Electrocardiography , Female , Fibrin Fibrinogen Degradation Products , Humans , Italy/epidemiology , Male , Middle Aged , Oxygen/blood , Pneumonia/drug therapy , Pneumonia/etiology , Pneumonia/mortality , Predictive Value of Tests , Prospective Studies , Respiratory Distress Syndrome/drug therapy , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/mortality
4.
Kardiol Pol ; 79(2): 129-138, 2021 02 25.
Article in English | MEDLINE | ID: covidwho-1598360

ABSTRACT

BACKGROUND: In children, palpitations, which may result from a life­threatening tachyarrhythmia, are one of the most common causes of cardiac visits and hospitalizations. Effective diagnosis is essential in this population of patients. AIMS: This study aimed to assess the usefulness of long­term telemetric electrocardiograms compared with Holter monitoring in the diagnostic workup in children with palpitations. METHODS: A total of 350 children with undocumented palpitations were examined in a multicenter study. In 167 patients (47.7%), the TELE group, month­long continuous telemetric electrocardiogram monitoring (using the PocketECG system) was performed. In 183 patients (52.3%), the HOLT group, 24­hour Holter electrocardiography was carried out and repeated after a month if tachyarrhythmia was not recorded. RESULTS: A total of 152 children (43.4%) reported palpitations, and 36.2% of them had sinus tachycardia during palpitations. Tachyarrhythmias were recorded in 68 patients (40.7%) in the TELE group and in 7 (3.8%) in the HOLT group after the second examination (P <0.001); the mean time to record tachycardia was 15.8 (8.7) days versus 25.4 (11.1) days (P = 0.004). In the TELE group, we noted a greater number of children with palpitations during recording (62.9% vs 18%), tachycardia with normal QRS complexes (21.6% vs 1.6%), ventricular tachycardia (11.4% vs 0.5%), and asymptomatic arrhythmias than in the HOLT group. CONCLUSIONS: In children, long­term telemetric electrocardiogram monitoring using the PocketECG system is well tolerated and has a high diagnostic efficacy. In young patients with palpitations, telemetric cardiac monitoring lasting up to a month increased the number of patients with recorded tachyarrhythmia by almost 10-fold compared with the analysis of 2 Holter electrocardiograms. We found that a large number of children have asymptomatic cardiac arrhythmias.


Subject(s)
Arrhythmias, Cardiac , Tachycardia, Ventricular , Arrhythmias, Cardiac/diagnosis , Child , Electrocardiography , Electrocardiography, Ambulatory , Humans , Telemetry
6.
Stud Health Technol Inform ; 281: 820-821, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1247813

ABSTRACT

Due to the fast-spreading of COVID-19 during the pandemic, decision-makers turned into innovative digital solutions for data collection in order to make well-informed public health decisions based on reliable data from verified sources. This work describes one of such solutions, implemented in partnership with the Ministry of Health in Argentina.


Subject(s)
COVID-19 , Argentina , Humans , Intensive Care Units , SARS-CoV-2 , Telemetry
8.
J Electrocardiol ; 67: 1-6, 2021.
Article in English | MEDLINE | ID: covidwho-1222930

ABSTRACT

BACKGROUND: Minimizing direct patient contact among healthcare personnel is crucial for mitigating infectious risk during the coronavirus disease 2019 (COVID-19) pandemic. The use of remote cardiac telemetry as an alternative to 12­lead electrocardiography (ECG) for continuous QTc monitoring may facilitate this strategy, but its application has not yet been validated or implemented. METHODS: In the validation component of this two-part prospective cohort study, a total of 65 hospitalized patients with simultaneous ECG and telemetry were identified. QTc obtained via remote telemetry as measured by 3 independent, blinded operators were compared with ECG as assessed by 2 board-certified electrophysiologists as the gold-standard. Pearson correlation coefficients were calculated to measure the strength of linear correlation between the two methods. In a separate cohort comprised of 68 COVID-19 patients treated with combined hydroxychloroquine and azithromycin, telemetry-based QTc values were compared at serial time points after medication administration using Friedman rank-sum test of repeated measures. RESULTS: Telemetry-based QTc measurements highly correlated with QTc values derived from ECG, with correlation coefficients of 0.74, 0.79, 0.85 (individual operators), and 0.84 (mean of all operators). Among the COVID-19 cohort, treatment led to a median QTc increase of 15 milliseconds between baseline and following the 9th dose (p = 0.002), with 8 (12%) patients exhibiting an increase in QTc ≥ 60 milliseconds and 4 (6%) developing QTc ≥ 500 milliseconds. CONCLUSIONS: Cardiac telemetry is a validated clinical tool for QTc monitoring that may serve an expanding role during the COVID-19 pandemic strengthened by its remote and continuous monitoring capability and ubiquitous presence throughout hospitals.


Subject(s)
COVID-19 , Long QT Syndrome , Delivery of Health Care , Electrocardiography , Humans , Long QT Syndrome/diagnosis , Long QT Syndrome/epidemiology , Pandemics , Prospective Studies , SARS-CoV-2 , Telemetry
9.
Sensors (Basel) ; 21(7)2021 Mar 26.
Article in English | MEDLINE | ID: covidwho-1154480

ABSTRACT

Coronavirus disease 19 (COVID-19) is a virus that spreads through contact with the respiratory droplets of infected persons, so quarantine is mandatory to break the infection chain. This paper proposes a wearable device with the Internet of Things (IoT) integration for real-time monitoring of body temperature the indoor condition via an alert system to the person in quarantine. The alert is transferred when the body thermal exceeds the allowed threshold temperature. Moreover, an algorithm Repetition Spikes Counter (RSC) based on an accelerometer is employed in the role of human activity recognition to realize whether the quarantined person is doing physical exercise or not, for auto-adjustment of threshold temperature. The real-time warning and stored data analysis support the family members/doctors in following and updating the quarantined people's body temperature behavior in the tele-distance. The experiment includes an M5stickC wearable device, a Microelectromechanical system (MEMS) accelerometer, an infrared thermometer, and a digital temperature sensor equipped with the user's wrist. The indoor temperature and humidity are measured to restrict the virus spread and supervise the room condition of the person in quarantine. The information is transferred to the cloud via Wi-Fi with Message Queue Telemetry Transport (MQTT) broker. The Bluetooth is integrated as an option for the data transfer from the self-isolated person to the electronic device of a family member in the case of Wi-Fi failed connection. The tested result was obtained from a student in quarantine for 14 days. The designed system successfully monitored the body temperature, exercise activity, and indoor condition of the quarantined person that handy during the Covid-19 pandemic.


Subject(s)
Accelerometry , Body Temperature , COVID-19 , Internet of Things , Micro-Electrical-Mechanical Systems , Quarantine , Thermometry , Humans , Pandemics , Telemetry
10.
J Diabetes Investig ; 12(10): 1923-1924, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1142911

ABSTRACT

This prospective study provided an effective way of glucose monitoring for patients with diabetes complicated with coronavirus disease 2019. The use of an intermittently scanned continuous glucose monitoring system was significantly associated with better outcomes of coronavirus disease 2019 in patients with pre-existing diabetes.


Subject(s)
Blood Glucose/analysis , COVID-19/complications , Diabetes Mellitus/blood , Monitoring, Ambulatory , Aged , COVID-19/blood , Female , Humans , Male , Middle Aged , Prospective Studies , Telemetry
11.
Sensors (Basel) ; 21(6)2021 Mar 13.
Article in English | MEDLINE | ID: covidwho-1136536

ABSTRACT

In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman's rank-order correlation coefficients and Bland-Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = -0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.


Subject(s)
Accelerometry/instrumentation , Actigraphy/instrumentation , Exercise/physiology , Monitoring, Ambulatory/instrumentation , Sleep/physiology , Telemedicine , Telemetry/standards , Adolescent , Adult , COVID-19 , Female , Humans , Male , Middle Aged , Monitoring, Ambulatory/standards , Pandemics , Reproducibility of Results , SARS-CoV-2
12.
Semin Ophthalmol ; 36(4): 310-314, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1125541

ABSTRACT

Technological advances provide a number of options for glaucoma monitoring outside the office setting, including home-based tonometry and perimetry. This has the potential to revolutionize management of this chronic disease, improve access to care, and enhance patient engagement. Here, we provide an overview of existing technologies for home-based glaucoma monitoring. We also discuss areas for future research and the potential applications of these technologies to telemedicine, which has been brought to the forefront during the ongoing COVID-19 pandemic.


Subject(s)
Diagnostic Techniques, Ophthalmological/trends , Glaucoma/diagnosis , Monitoring, Ambulatory , Telemedicine/trends , Telemetry/instrumentation , Biomedical Technology/trends , Glaucoma/physiopathology , Humans , Intraocular Pressure/physiology , Ophthalmology/trends , Self Care/methods , Tomography, Optical Coherence/methods , Tonometry, Ocular/methods , Visual Field Tests/methods
13.
Saudi Med J ; 41(11): 1211-1216, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-1125363

ABSTRACT

OBJECTIVES: To study the impact of curfews during the COVID-19 pandemic, on the physical activity in patients of heart failure implanted withcardiac implantable electronic devices (CIEDs). METHODS: This was a retrospective single-center study of heart failure patients inserted with remote monitoring (RM)-capable CIED. We analyzed the transmitted data of physical activity and fluid volume status of all patients, before, and during the lockdown periods between February and April 2020. The clinical status of the patients was also evaluated.  Results: Device data from 429 patients implanted with CIED capable of RM were initially evaluated. Patients with an implantable loop recorder, Brugada or Long QT syndromes, and patients with incomplete transmissions were excluded. Eighty-two patients with heart failure were included. The median age was 65 years (58-72), and 53 (64.6%) subjects were men. There was a 27.1% decline in physical activity, and the median physical activity of patients significantly declined from 2.4 to 1.8 hours/day (p=0.000010).  Conclusion: Data obtained by remotely monitored CIED in heart failure patients suggests a significant decline in physical activity during the country lockdown due to the pandemic. Awareness of the future potential hazards in this group of patients is warranted.


Subject(s)
Coronavirus Infections/prevention & control , Defibrillators, Implantable/statistics & numerical data , Exercise/physiology , Heart Failure/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/statistics & numerical data , Telemetry/methods , Aged , COVID-19 , Cohort Studies , Coronavirus Infections/epidemiology , Female , Heart Failure/diagnosis , Humans , Male , Middle Aged , Monitoring, Physiologic/methods , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Prognosis , Quarantine/methods , Retrospective Studies , Risk Assessment , Saudi Arabia , Sedentary Behavior , Survival Rate
14.
Intensive Care Med ; 47(2): 150-153, 2021 02.
Article in English | MEDLINE | ID: covidwho-1086552
15.
Sensors (Basel) ; 21(3)2021 Jan 28.
Article in English | MEDLINE | ID: covidwho-1059905

ABSTRACT

Heart failure (HF) is a major health care issue, and the incidence of HF is only expected to grow further. Due to the frequent hospitalizations, HF places a major burden on the available hospital and healthcare resources. In the future, HF care should not only be organized solely at the clinical ward and outpatient clinics, but remote monitoring strategies are urgently needed to guide, monitor, and treat chronic HF patients remotely from their homes as well. The intuitiveness and relatively low costs of non-invasive remote monitoring tools make them an appealing and emerging concept for developing new medical apps and devices. The recent COVID-19 pandemic and the associated transition of patient care outside the hospital will boost the development of remote monitoring tools, and many strategies will be reinvented with modern tools. However, it is important to look carefully at the inconsistencies that have been reported in non-invasive remote monitoring effectiveness. With this review, we provide an up-to-date overview of the available evidence on non-invasive remote monitoring in chronic HF patients and provide future perspectives that may significantly benefit the broader group of HF patients.


Subject(s)
Continuity of Patient Care/trends , Heart Failure/therapy , Monitoring, Physiologic/methods , Telemedicine/trends , COVID-19 , Heart Failure/diagnosis , Humans , Pandemics , SARS-CoV-2 , Telemetry , Telenursing
16.
Heart Lung Circ ; 30(7): 1044-1049, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1051657

ABSTRACT

BACKGROUND: In the era of COVID-19, travel restrictions and social distancing measures have changed the landscape for device interrogations of pacemakers and defibrillators for rural Victorians. Previously, device checks were performed infrequently in large volume, face-to-face rural clinics by visiting cardiologists and technicians. Access to remote areas and social distancing restrictions have made these clinics unfeasible to operate. The Cardiac Society of Australia and New Zealand (CSANZ) and Heart Rhythm Society (HRS) COVID-19 consensus statements have suggested the utilisation of remote monitoring to minimise the potential spread of COVID-19 infections between clinicians and high-risk patients. A novel solution to this challenge was the implementation of a remote device interrogation (RI) service located in two kiosks at two rural pharmacies. This service was termed Remote Device Interrogation Kiosks (ReDInK). AIM: This cross-sectional observational study aimed to describe the set-up process, safety and efficacy of RI and customer satisfaction of the ReDInK program. METHODS: Two-hundred-and-ninety-two (292) rurally located patients with implantable cardiac devices were identified via the cardiology department database. Of these, 101 (44%) were enrolled into the ReDInK program across two rurally located pharmacies between April and July 2020. RI was performed and download outcomes were reviewed. A customer satisfaction survey assessed attitudes towards the program and explored options of ongoing service application. RESULTS: Of 101 patients enrolled into ReDInK, 96 (95%) resulted in satisfactory device checks. Four (4) individuals failed-to-attend and one individual experienced technical download issues. Of the 96 satisfactory device checks, three required in-person follow-up for reasons including battery replacement, lead repositioning and in-person programming. No adverse events were reported. A satisfaction telephone survey was conducted with 81 (83%) participants enrolled in ReDInK. Seventy-one (71) individuals (88%) of those surveyed expressed satisfaction and 73 (90%) labelled the process as efficiently conducted. Sixty-nine (69) (85%) participants felt reassured that this service was established during the pandemic. However 47 (58%) participants reported they would still feel comfortable to undergo in-person reviews despite social distancing recommendations. CONCLUSIONS: With the COVID-19 pandemic posing restrictions to social distancing and reducing unnecessary in-person interaction, the ReDInK program emerges as an efficacious and safe solution for patients in rural Victoria. The program's widely positive reception and successful conduction in rural Victoria invites further opportunity for a wider application of similar programs, expanding its role to metropolitan areas.


Subject(s)
COVID-19/prevention & control , Defibrillators, Implantable , Pacemaker, Artificial , Patient Satisfaction , Rural Health Services , Telemetry , Aged , Cross-Sectional Studies , Female , Humans , Male , Pharmacies , Telemetry/instrumentation , Victoria
17.
Biosens Bioelectron ; 178: 113007, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1046560

ABSTRACT

Recent progress in biosensors have quantitively expanded current capabilities in exploratory research tools, diagnostics and therapeutics. This rapid pace in sensor development has been accentuated by vast improvements in data analysis methods in the form of machine learning and artificial intelligence that, together, promise fantastic opportunities in chronic sensing of biosignals to enable preventative screening, automated diagnosis, and tools for personalized treatment strategies. At the same time, the importance of widely accessible personal monitoring has become evident by recent events such as the COVID-19 pandemic. Progress in fully integrated and chronic sensing solutions is therefore increasingly important. Chronic operation, however, is not truly possible with tethered approaches or bulky, battery-powered systems that require frequent user interaction. A solution for this integration challenge is offered by wireless and battery-free platforms that enable continuous collection of biosignals. This review summarizes current approaches to realize such device architectures and discusses their building blocks. Specifically, power supplies, wireless communication methods and compatible sensing modalities in the context of most prevalent implementations in target organ systems. Additionally, we highlight examples of current embodiments that quantitively expand sensing capabilities because of their use of wireless and battery-free architectures.


Subject(s)
Biosensing Techniques/instrumentation , Wireless Technology/instrumentation , Artificial Intelligence , Bioelectric Energy Sources , Biosensing Techniques/trends , COVID-19/physiopathology , Electric Power Supplies , Electrophysiological Phenomena , Equipment Design , Humans , Pandemics , Remote Sensing Technology/instrumentation , SARS-CoV-2 , Telemetry/instrumentation , Wearable Electronic Devices , Wireless Technology/trends
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