A Survey of Telecardiology Projects in Italy.

It is estimated that in Italy there are about three million people affected by chronic heart failure. Cardiology is the health care field currently getting the largest benefits from telemedicine. Transmission, using wireless devices, makes possible to achieve virtual hospitalization: it is possible to anticipate the time of discharging and the patient can be remotely controlled by the central station in the ICU of the department of Medicine. Teleconsulting (i.e. a distance consulting between physicians) is applied in telecardiology, it allows the realization of a consulting between cardiology departments and remote services in the same hospital or among far-away hospitals. In this paper some of the most significant cardiac telemonitoring projects in Italy are described. Also reported, the projects involving the applications of implantable cardiac devices which can be controlled remotely. In conclusion, we sketch out the future prospects of telecardiology research and its applications in Italy

A Survey of Telecardiology Projects in Italy

It is estimated that in Italy there are about three million people affected by chronic heart failure. Cardiology is the health care field currently getting the largest benefits from telemedicine. Transmission, using wireless devices, makes possible to achieve virtual hospitalization: it is possible to anticipate the time of discharging and the patient can be remotely controlled by the central station in the ICU of the department of Medicine. Teleconsulting (i.e. a distance consulting between physicians) is applied in telecardiology, it allows the realization of a consulting between cardiology departments and remote services in the same hospital or among far-away hospitals. In this paper some of the most significant cardiac telemonitoring projects in Italy are described. Also reported, the projects involving the applications of implantable cardiac devices which can be controlled remotely. In conclusion, we sketch out the future prospects of telecardiology research and its applications in Italy

Qualidade pós-colheita do tomate de mesa convencional e orgânico.

O presente trabalho teve como objetivo avaliar a qualidade pós-colheita de frutos de tomate de mesa de diferentes sistemas de cultivos. As amostras de tomate convencional, cv. Raísa (LV), e orgânico, cv. Santa Clara, foram mantidas a uma temperatura de 23,5 ± 2 °C, com UR de 74% ± 5 e submetidas a análise da massa, peso específico, cinzas, sólidos totais, sólidos solúveis totais, acidez titulável total, relação sólidos solúveis totais/acidez titulável total, pH, vitamina C, Salmonella spp., coliformes totais, coliformes fecais, bolores e leveduras e análise sensorial, que foi realizada pela Análise Descritiva Quantitativa - ADQ. O tempo de armazenagem foi de 13 e 14 dias para o tomate de mesa cultivado nos sistemas convencional e orgânico, respectivamente. O tempo de armazenagem foi de 13 e 14 dias para o tomate de mesa cultivado nos sistemas convencional e orgânico, respectivamente. A perda de massa foi significativamente inferior (3,74%) no tomate convencional. Ambas as amostras apresentaram similar comportamento na análise física, química sensorial e microbiológica nos estádios de maturação

Índice de treinamento de enfermagem enquanto indicador de qualidade de gestão de recursos humanos

Aim: determine the index of training of nursing professionals. Method: this paper consists in a retrospective, descriptive study based on a quantitative approach. It was developed in a teaching hospital in Paraná State and it focused on training activities related to nursing professionals as its object of study. Results: the index of training was found is about 16,20 related to nursing professionals and about 3,98 to technical nursing assistants and auxiliaries. Conclusion: the numbers found in this training index can be understood as favorable (positive) concerning about nursing professionals and unfavorable (negative) in relation to a nursing professional of meddium level (position), when all of them are compared to the shortage of literature produced by the nursing.Objetivo: determinar el índice de entrenamiento de profesionales de enfermería. Método: estudio retrospectivo, descriptivo, con abordaje cuantitativo. Desarrollado en un hospital escuela en el estado del Paraná considerando como objeto de estudio las actividades de entrenamiento direccionadas a los profesionales de enfermería. Resultados: el índice de entrenamiento encontrado fue de 16,20 para los profesionales enfermeros y de 3,98 para profesionales técnicos y auxiliares de enfermería. Conclusión: los valores del índice de entrenamiento pueden ser interpretados como favorables a los enfermeros profesionales de nivel superior, y desfavorables a los profesionales de enfermería de nivel medio cuando comparados con la escasa literatura producida en el área de Enfermería.Objetivo: determinar o índice de treinamento de profissionais de enfermagem. Método: estudo retrospectivo, descritivo com abordagem quantitativa. Desenvolvido em um hospital de ensino no estado do Paraná com objeto de estudo as atividades de treinamento direcionadas para os profissionais de enfermagem. Resultados: o índice de treinamento encontrado foi de 16,20 para os profissionais enfermeiros e de 3,98 para técnicos e auxiliares de enfermagem. Conclusão: os valores encontrados do índice de treinamento podem ser interpretados como favoráveis aos profissionais enfermeiros e desfavoráveis aos profissionais de enfermagem de nível médio, quando estes comparados a escassa literatura produzida pela enfermagem

Screening high school students in Italy for sudden cardiac death prevention by using a telecardiology device. a retrospective observational study

BACKGROUND: In 2010, an Italian project was launched aimed at using a telecardiology device in order to perform early diagnosis of young students at risk of sudden cardiac death. METHODS: Our retrospective observational study was conducted on a population of 13,016 students, aged between 16 and 19 years, in different Italian regions. It consisted of analysis of data recorded during a telecardiology pilot study. The recorded data were electrocardiograms and data concerning lifestyle habits and family history of cardiovascular diseases. In total, 14 alterations in the electrocardiogram signal have been considered in this study. Some of these alterations are as follows: ventricular ectopic beats, atrioventricular block, Brugada-like electrocardiogram pattern, left anterior/posterior fascicular block, left/right ventricular hypertrophy, long/short QT interval, left atrial enlargement, right atrial enlargement, short PQ interval, and ventricular pre-excitation Wolff-Parkinson-White syndrome. On the basis of the collected data, we implemented this retrospective observational study. RESULTS: The analysed data showed that 13.60% of students had a family history for cardiovascular diseases, 22.43% reported smoking habits, 26.23% reported alcohol consumption, and 7.24% reported abuse of drugs. A total of 24% of students had at least one of the 14 electrocardiogram pathological alterations considered in our study and 32% had electrocardiogram values within the normal range. CONCLUSIONS: This retrospective observational study analysed data registered during our telecardiology activity. This activity permitted to maximise data collection and minimise the costs for collecting such data. This activity of screening is being continued and in the next few years it will allow us to have a greater mass of data

PERFIL SENSORIAL DO TOMATE DE MESA (Lycopersicon esculentum Mill.) ORGÂNICO

Foram avaliadas, pela análise descritiva quantitativa - ADQ, quatro amostras de tomate de mesa, Lycopersicon esculentum Mill., cultivadas pelo sistema orgânico e comercializadas de dezembro de 2001 a fevereiro de 2002. A comparação realizada pelo teste de Tukey revelou que nos descritores defeitos de superfície, cor, firmeza ao toque, firmeza ao corte, resistência ao corte, aparência geral externa, espessura da polpa, sabor estranho, textura oral, doçura e acidez as amostras apresentaram diferença em nível de 5% de probabilidade de erro. Nos atributos grau de suculência, característica da polpa, aroma, sabor, sabor remanescente, aparência geral interna e qualidade global as amostras não diferiram entre si. SENSORY PROFILE OF ORGANIC TOMATO (Lycopersicon esculentum Mill.) Abstract Using Quantitative Descriptive Analysis (QDA), four samples of salad tomatoes (Lycopersicon esculentum Mill) were evaluated. The samples were organic grown tomatoes, commercialized from December 2001 to February 2002. Comparison using Tukey 5% revealed significant difference concerning the following descriptors: surface defects, color, firmness to touch, firmness to cut, resistance to cut, overall exterior appearance, pulp thickness, strange taste, oral texture, sweetness and acidity. The descriptors juiciness, pulp characteristic, smell, taste, after taste, overall interior appearance and overall quality showed no significant difference

Erratum: Evaluation of a new, rapid, simple test for the detection of influenza virus

Following publication of [1] it has come to our attention that there was an error in the authorship order and in Jordi Vila's name, which should be Jordi Vila and not Jordi Vila Estape. We would like to sincerely apologize for the error and any inconvenience caused

NURSING CARE QUALITY IN PERIPHERAL INTRAVENOUS THERAPY: ANALYSIS BY INDICATORS

Pesquisa de delineamento longitudinal com abordagem observacional e quantitativa que teve como objetivo analisar a qualidade da assistência de enfermagem na terapia intravenosa periférica, por meio dos indicadores incidência de flebite, qualidade da cobertura e validade dos cateteres intravenosos periféricos. Os dados foram coletados de outubro de 2012 a agosto de 2013, em três unidades de um hospital de ensino do Estado do Paraná-Brasil, utilizando formulário próprio. Foram avaliados 174 pacientes e 221 cateteres. Os resultados indicaram incidência de flebite entre 20% e 25,33%; a identificação e a validade dos acessos venosos foram classificadas, em sua maioria, como seguras e adequadas segundo análise do Índice de Positividade que classifica a atividade assistencial. Conclui-se que os indicadores avaliados podem ser interpretados, em sua maioria, como favoráveis à qualidade assistencial.Investigación de delineación longitudinal con abordaje observacional y cuantitativa que tuvo como objetivo analizar la cualidad de la asistencia de enfermería en la terapia intravenosa periférica, por medio de los indicadores incidencia de flebitis, cualidad de la cober tura y validez de los catéteres intravenosos periféricos. Los datos fueron recogidos de octubre de 2012 a agosto de 2013, en tres unidades de un hospital de enseñanza del Estado de Paraná, Brasil, utilizando formulario propio. Fueron evaluados 174 pacientes y 221 catéteres. Los resultados apuntan incidencia de flebitis entre 20% y 25,33%; la identificación y la validez de los accesos venosos fueron clasificadas como seguras y adecuadas en su mayoría, de acuerdo con análisis de Índice de Positividad que clasifica la actividad asistencial. Se concluye que los indicadores evaluados pueden ser interpretados, en su mayoría, como favorables a la cualidad asistencial.This Longitudinal study, with an observational and quantitative approach, aimed to analyze the quality of nursing care in peripheral intravenous therapy, through the indicators, incidence of phlebitis, quality of coverage, and validity of the peripheral intravenous catheters. Data were collected from October 2012 to August 2013, in three units of a teaching hospital in the state of Paraná, Brazil, using a form created for this purpose. A total of 174 patients and 221 catheters were evaluated. The results indicated an incidence of phlebitis between 20% and 25.33%; identification and the validity of the venous accesses were classified as safe and adequate in the majority of cases, according to an analysis of the Positivity Index that classifies medical work. It was concluded that the evaluated indicators could mostly be interpreted as favorable for care quality

Evaluation of a new, rapid, simple test for the detection of influenza virus

Influenza virus infections are responsible for significant morbidity and mortality in both pediatric and adult populations worldwide. Rapid and accurate diagnosis of influenza is necessary for appropriate patient management during the influenza season and for optimal utilization of anti-influenza therapy. We prospectively tested the accuracy of a simple and rapid diagnostic method. Ninety-eight samples (nasal and pharyngeal swabs) from patients with upper respiratory tract infection symptoms who presented to primary healthcare centres in Barcelona (Spain) were prospectively analyzed. The samples were collected as part of influenza surveillance program. Samples that had enough volume to make the new test after aliquoting the amount needed to perform routine tests were included. None of the samples were pre-selected as a result of their status in relation to influenza virus. Samples were analyzed by in-house real-time PCR and Alere™ i Influenza A & B (Alere™ i), which uses isothermal amplification of nucleic acids for the qualitative detection of influenza A and B in nasal swabs transported in viral transport media. The two techniques were compared by positive percent agreement (PPA) and negative percent agreement (NPA). Statistical analysis was performed with Stata. Of the 98 samples analysed 90 were concordant; 46 (46.9%) were positive and 44 (44.9%) were negative. Five samples showed invalid results with the Alere™ i test and could be not re-tested due to insufficient sample volume and were not included in the final statistical analysis. In the 93 remaining samples, the Alere™ i test showed 97% of accuracy having correctly classified 90 samples. We obtained discordant results in 3 samples (3%). The PPA was 93.8% for influenza A and 94.1% for influenza B, and NPA was 100% for influenza A and influenza B virus. In addition, the Alere™ i was very rapid (15 minutes or less) and extremely easy to use. The Alere™ i test provided a good correlation compared to the real-time PCR test for the diagnosis of influenza. Since this method can be performed in minutes, it allows immediate, accurate clinical decisions to prescribe appropriate antiviral treatment or isolation of patients

Haemophilus ducreyi as a cause of skin ulcers in children from a yaws-endemic area of Papua New Guinea: a prospective cohort study

Background Skin infections with ulceration are a major health problem in countries of the south Pacifi c region. Yaws, caused by Treponema pallidum subspecies pertenue and diagnosed by the presence of skin ulcers and a reactive syphilis serology, is one major cause, but this infection can be confused clinically with ulcers due to other causative agents. We investigated T pallidum pertenue and another bacterium known to cause skin infections in the Pacifi c islands— Haemophilus ducreyi—as causes of skin ulceration in a yaws-endemic region. Additionally, we identifi ed specifi c signs and symptoms associated with these causative agents of cutaneous ulcers and compared these fi ndings with laboratory-based diagnoses. Methods We did a prospective cohort study of fi ve yaws-endemic villages (total population 3117 people) during a yaws elimination campaign in Papua New Guinea in April, 2013. We enrolled all consenting patients with chronic moist or exudative skin ulcers. We undertook a detailed dermatological assessment, syphilis serology, and PCR on lesional swabs to detect the presence of T pallidum pertenue and H ducreyi. Patients with PCR-confi rmed bacterial infections were included in a comparative analysis of demographics and clinical features. Findings Full outcome data were available for 90 people with skin ulcers. Of these patients, 17 (19%) had negative results in all molecular tests and were therefore excluded from the comparative analyses. A bacterial cause was identifi ed in 73 (81%) participants—either H ducreyi (n=42), T pallidum pertenue (yaws; n=19), or coinfection with both organisms (dual infection; n=12). The demographic characteristics of the patients infected with yaws and with H ducreyi were similar. Skin lesions in patients with yaws and in those with dual infection were larger than those in patients infected with H ducreyi (p=0·071). The lesions in patients with yaws and dual infection were more circular in shape (79% and 67%) than in those infected with H ducreyi (21%; p<0·0001); more likely to have central granulating tissue (90% and 67% vs 14%; p<0·0001); and more likely to have indurated edges (74% and 83% vs 31%; p=0·0003). The prevalence of reactive combined serology (positive T pallidum haemagglutination test and rapid plasmin reagin titre of ≥1:8) was higher in cases of yaws (63%) and dual infections (92%) than in H ducreyi infections (29%; p<0·0001). Interpretation In this yaws-endemic community, H ducreyi is an important and previously unrecognised cause of chronic skin ulceration. Reactive syphilis serology caused by latent yaws can occur in ulcers with the presence of H ducreyi alone. The introduction of PCR for ulcer surveillance could improve the accuracy of diagnosis in countries with yaws eradication campaigns