34 research outputs found
Care4Value:measuring value in health in integrated continuous care units
Objective:
To develop a digital platform for optimizing data collection processes with medical scales and monitoring data for measuring value in health.
Method:
Using an investigative intervention methodology, a platform was developed including qualitative and quantitative approaches in three phases: focal groups were conducted by a multidisciplinary team of investigators and healthcare providers at the pilot study site, an Integrated Continuous Care Unit (UCCI); data from a sample of 21 UCCI users was analyzed as a pre-test to classify different levels of complexity; UCCI financial data and operational costs were collected and analyzed during the 21 users stay at the UCCI. The platform’s iteractive and incremental development allowed for the collection of as a form of improvement.
Results:
The platform includes three modules: a mobile application; a dashboard; and an import module. Data collected on the platform are centralized and shown on the dashboard. Data are collected using a mobile application and/or an import module to input data from existing medical systems.
Conclusion:
The mobile application is ready to be used by healthcare providers and caregivers. The dashboard shows users’ clinical follow-up and health gain data for monitoring.info:eu-repo/semantics/publishedVersio
Correlação da intensidade do sinal em FLAIR e os nÃveis de mediadores inflamatórios no hipocampo de pacientes com epilepsia do lobo temporal e esclerose mesial temporal
We investigated a relationship between the FLAIR signal found in mesial temporal sclerosis (MTS) and inflammation. Twenty nine patients were selected through clinical and MRI analysis and submitted to cortico-amygdalo-hippocampectomy to seizure control. Glutamate, TNFα, IL1, nitric oxide (NO) levels and immunostaining against IL1β and CD45 was performed. Control tissues (n=10) were obtained after autopsy of patients without neurological disorders. The glutamate was decreased in the temporal lobe epilepsy (TLE) -MTS group (p<0.001), suggesting increased release of this neurotransmitter. The IL1β and TNFα were increased in the hippocampus (p<0.05) demonstrating an active inflammatory process. A positive linear correlation between FLAIR signal and NO and IL1β levels and a negative linear correlation between FLAIR signal and glutamate concentration was found. Lymphocytes infiltrates were present in hippocampi of TLE patients. These data showed an association between hippocampal signal alteration and increased inflammatory markers in TLE-MTS.Este estudo foi delineado para investigar a presença de relação entre a intensidade de sinal em FLAIR e nÃveis de citocinas, óxido nÃtrico (NO) e glutamato no hipocampo de pacientes com epilepsia do lobo temporal refratária, associada com esclerose mesial (TLE-MTS). Vinte e nove pacientes foram selecionados através de análise clÃnica e de ressonância magnética (RM) que foram submetidos a cortico-amigdalo-hipocampectomia para o controle das crises. Os nÃveis de glutamato foram avaliados por HPLC, as citocinas TNFα e IL1β por ELISA e os nÃveis de NO via NO system. Avaliamos também por imuno-histoquÃmica a expressão de IL1β e CD45 em tecidos controles e com esclerose. Tecido controle foi obtido após autópsia de indivÃduos mortos sem disfunções inflamatórias e neurológicas (n=10). A concentração de glutamato se mostrou reduzida no tecido TLE-MTS (p<0,001) sugerindo aumento na liberação desse neurotransmissor. TNFα e IL1β também apresentaram nÃveis elevados no hipocampo dos pacientes (p<0,05), demonstrando um processo inflamatório crônico. Houve uma correlação linear positiva entre a intensidade do sinal em FLAIR e os nÃveis de NO e IL1β. Em contraste, uma correlação linear negativa foi encontrada entre a intensidade do sinal em FLAIR e nÃveis de glutamato no hipocampo com esclerose. Infiltrado linfocitário hipocampal também foi visualizado pela imuno-marcação com CD45 em pacientes com TLE-MTS. Esses dados mostraram uma associação entre alteração de sinal na RM e marcadores inflamatórios em pacientes com TLE-MTS.FAPESP - CInNAPCeCNPqMCT - Instituto Nacional de Neurociência Translaciona