Ubiquitous healthcare profile management applying smart card technology

Nowadays, the patient-centric healthcare approach is focused on ubiquitous healthcare services. Furthermore, the adoption of cloud computing technology leads to more efficient ubiquitous healthcare systems. Moreover, the personalization of the delivery of ubiquitous healthcare services is enabled with the introduction of user profiles. In this paper, we propose five generic healthcare profile structures corresponding to the main categories of the participating entities included in a typical ubiquitous healthcare system in a cloud computing environment. In addition, we propose a profile management system incorporating smart card technology to increase its efficiency and the quality of the provided services of the ubiquitous healthcare system

PKI security in large-scale healthcare networks

During the past few years a lot of PKI (Public Key Infrastructures) infrastructures have been proposed for healthcare networks in order to ensure secure communication services and exchange of data among healthcare professionals. However, there is a plethora of challenges in these healthcare PKI infrastructures. Especially, there are a lot of challenges for PKI infrastructures deployed over large-scale healthcare networks. In this paper, we propose a PKI infrastructure to ensure security in a large-scale Internet-based healthcare network connecting a wide spectrum of healthcare units geographically distributed within a wide region. Furthermore, the proposed PKI infrastructure facilitates the trust issues that arise in a large-scale healthcare network including multi-domain PKI infrastructures

A new framework for ubiquitous context-aware healthcare applications

Nowadays, there is a significant lack of generic application frameworks providing third party developers with the appropriate mechanisms for building ubiquitous contextaware healthcare applications over medical heterogeneous networks. In this paper, we propose a new framework integrating context-aware and security mechanisms with mechanisms that allow the ease exploitation of the core networks’ functionality to enable third party developers to build reliable and secure ubiquitous context-aware healthcare applications over medical heterogeneous networks

A new framework architecture for next generation e-Health services

The challenge for fast and low-cost deployment of ubiquitous personalized e-Health services has prompted us to propose a new framework architecture for such services. We have studied the operational features and the environment of e-Health services and we led to a framework structure that extends the ETSI/Parlay architecture, which is used for the deployment of standardized services over the next generation IP networks. We expanded the ETSI/Parlay architecture with new service capability features as well as sensor, profiling and security mechanisms. The proposed framework assists the seamless integration, within the e-Health service structure, of diverse facilities provided by both the underlying communication and computing infrastructure as well as the patient's bio and context sensor networks. Finally, we demonstrate the deployment of a tele-monitoring service in smart home environment based on the proposed framework architecture

Adaptation of a Conference Key Distribution System for the Wireless Ad Hoc Network

In this paper we review previous works done with respect to Conference Key Distribution Systems (CKDS). We focus on the system proposed by Kim et al. and we propose improvements on that scheme a) from the perspective of security and anonymity, b) from the perspective of efficient calculation of the Lagrange polynomial coefficients, and c) from the perspective of adaptation into the dynamic wireless ad hoc network. The security of the proposed scheme is based on the difficulty of computing discrete logarithms over elliptic curves, the intractability of inverting a one-way hash function and the pseudo-randomness of user coordinates. We demonstrate the effectiveness of the proposed scheme through the analysis of characteristic attack scenarios

Ultrasound 3D reconstruction of malignant masses in robotic-assisted partial nephrectomy using the PAF rail system: a comparison study

PURPOSE: In robotic-assisted partial nephrectomy (RAPN), the use of intraoperative ultrasound (IOUS) helps to localise and outline the tumours as well as the blood vessels within the kidney. The aim of this work is to evaluate the use of the pneumatically attachable flexible (PAF) rail system for US 3D reconstruction of malignant masses in RAPN. The PAF rail system is a novel device developed and previously presented by the authors to enable track-guided US scanning. METHODS: We present a comparison study between US 3D reconstruction of masses based on: the da Vinci Surgical System kinematics, single- and stereo-camera tracking of visual markers embedded on the probe. An US-realistic kidney phantom embedding a mass is used for testing. A new design for the US probe attachment to enhance the performance of the kinematic approach is presented. A feature extraction algorithm is proposed to detect the margins of the targeted mass in US images. RESULTS: To evaluate the performance of the investigated approaches the resulting 3D reconstructions have been compared to a CT scan of the phantom. The data collected indicates that single camera reconstruction outperformed the other approaches, reconstructing with a sub-millimetre accuracy the targeted mass. CONCLUSIONS: This work demonstrates that the PAF rail system provides a reliable platform to enable accurate US 3D reconstruction of masses in RAPN procedures. The proposed system has also the potential to be employed in other surgical procedures such as hepatectomy or laparoscopic liver resection

Anatomical variations of the pelvis during abdominal hysterectomy for benign conditions

Background: Anatomical variations are defined as atypical morphologic and positional presentations of anatomical entities. Pelvic anatomical variations encountered during abdominal hysterectomy can be of clinical interest, given that misidentification of certain structures can lead to iatrogenic injuries and postoperative sequelae. The aim of the present study was to detect and highlight the anatomical structures of interest and their variations to the surgeon performing abdominal hysterectomy for benign conditions. Materials and methods: A narrative review of the literature was performed including reports of anatomical variations encountered in cadavers, by surgeons during abdominal hysterectomy and radiologists on computed tomography angiography, searching within a 10-year span on Pubmed database. Studies regarding the treatment of malignant conditions requiring lymphadenectomy and different modes of surgical approach were reviewed with regards to the aspects relevant to benign conditions. The search was extended to the reference lists of all retrieved articles. Results: Ureters and the uterine arteries, due to anatomical variations, are the anatomical structures most vulnerable during abdominal hysterectomy. Specifically, the ureters can present multiplications, retroiliac positionings and ureteric diverticula, whereas, the uterine arteries can present notable variability in their origins. Such variations can be detected preoperatively or intraoperatively. Conclusions: Although rare, the presence of anatomical variations of the uterine arteries and ureters can increase the posibility of complications should they escape detection. Intraoperative misidentification could lead to improper dissection or ligation of the affected structures. Knowledge of these variations, coupled with extensive preoperative investigation and intraoperative vigilance can minimize the risk of complications

Foreign body ingestion mimicking irritable bowel syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Foreign body ingestion is associated with a variety of symptoms and complications, often mimicking various diseases. This case report describes an unusual presentation following foreign body ingestion.</p> <p>Case presentation</p> <p>A 56-year-old Greek Caucasian woman presented to a primary care setting, in rural Crete, Greece, with complaints of abdominal pain, cramping and bloating, for the last four months. Alternating constipation and diarrhea was reported. The patient had unknowingly ingested a foreign body that resulted in an irritable bowel syndrome-like presentation.</p> <p>Conclusions</p> <p>This case report emphasizes the need for a high index of suspicion from physicians for a wide differential in their approach to abdominal complaints, as well as the importance of an individualized approach to patients in the setting of clinical medicine.</p

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

<p>Abstract</p> <p>Background</p> <p>Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.</p> <p>Methods</p> <p>The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).</p> <p>Results</p> <p>The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; <it>p </it>= 0.029).</p> <p>Conclusions</p> <p>The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.</p