Management of Onsite and Remote Communication in Oncology Hospitals: Data Protection in an Era of Rapid Technological Advances.

Modern communication and information technologies are rapidly being deployed at health care institutions around the world. Although these technologies offer many benefits, ensuring data protection is a major concern, and implementation of robust data protection measures is essential. In this context, health care providers and medical care facilities must frequently make difficult decisions and compromises between the need to provide effective medical care and the need to ensure data security and patient privacy. In the present paper, we describe and discuss key issues related to data protection systems in the setting of cancer care hospitals in Europe. We provide real-life examples from two European countries-Poland and the Czech Republic-to illustrate data protection issues and the steps being taking to address these questions. More specifically, we discuss the legal framework surrounding data protection and technical aspects related to patient authentication and communication.

Bland-White-Garland syndrome in adults: sudden cardiac death as a first symptom and long-term follow-up after successful resuscitation and surgery.

Two cases (a 23-year-old man and a 33 year-old-woman) with Bland-White-Garland (BWG) syndrome (an anomalous origin of the left coronary artery from the pulmonary artery) are presented. Their first symptom was survived sudden cardiac death. Both patients underwent surgical repair. One patient received an implantable defibrillator because of serious structural changes in the left ventricle and symptomatic non-sustained ventricular tachycardia; the second patient is free of therapy. During long-term follow-up (10.5 and 4.5 years, respectively), ventricular tachyarrhythmias did not recur. Both cases show good long-term prognosis in resuscitated adult patients after surgical repair for BWG syndrome regardless of the presence of structural changes.

The influence of fluid and diuretic administration on the index of atrial contribution in sequentially paced patients.

AIMS: To examine whether acute changes in patient hydration can change atrial contribution (AC) to circulatory function. METHODS AND RESULTS: Atrial contribution was quantified by beat-to-beat changes in the amplitude of pulse oximetry signal in 24 paced outpatients. Changes in body weight were used for assessment of changes in total body water. The first measurement was performed at steady state. The second measurement was made after infusion of saline (5 mL/kg) and the third measurement was obtained 2 h after a bolus of furosemide (1 mg/kg). Changes found after furosemide administration (compared with steady state): a substantial decrease in body weight from median 78.6 (interquartile range 65.7-86.5) to 77.1 (64.4-85.6) kg (P < 0.001), accompanied by an increase in AC from 30.4 (20.2-47.1) up to 43.3 (30.6-80.9)% (P < 0.001). An increase in heart rate and shortening of the atrioventricular conduction time occurred during acute hypohydration in some of the subjects. CONCLUSION: Administration of furosemide was followed by a decrease in body weight and an increase in AC to stroke volume. This suggests that in conditions where pre-load is reduced cardiac output is preserved by an increase in AC enforced by sympathetic activation.

Characteristics and short-term survival of individuals with out-of-hospital cardiac arrests in the East Bohemian region.

AIM: We describe survival after admission to hospital from out-of-hospital cardiac arrest (OHCA) in the East Bohemian region, according to the Utstein Style guidelines and have identified the main diagnosis including in those who died and had an autopsy. PATIENT GROUP: Over a period of 29 months we used a questionnaire supplied to 24 rescue stations, to identify 718 individuals (511 men and 207 women, aged 16-97 years) with confirmed cardiac arrest who were considered for resuscitation. RESULTS: Out of 560 patients in whom cardiopulmonary resuscitation for OHCA of confirmed cardiac aetiology was attempted, 350 patients (62.5%) died in the field and 61 (10.9%) died during transport. Hospital admission was achieved in 149 cases (26.6%) and, of these, 96 patients died. Fifty-three patients (9.5%) were discharged home alive, 36 (6.4%) with an intact CNS. The first monitored rhythm showed asystole in 264 cases (47.1%) followed by ventricular fibrillation in 227 cases (40.5%). The main diagnosis of coronary heart disease (CHD) was established clinically in 467 cases (83.4%). In 175 autopsy reports this diagnosis was noted in 152 cases (86.9%). CONCLUSION: Of patients resuscitated for OHCA of cardiac aetiology, 9.5% survived to leave the acute hospital. CHD was the principle diagnosis in the entire group and this correlated with the same finding in the group of patients who received an autopsy.