Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2008
Inclusion and assessment criteria for conservative scoliosis treatment.
The efficacy of brace or conservative treatment in adolescent idiopathic scoliosis is controversial due to variations in inclusion and assessment criteria. This makes the interpretation of brace studies and their comparisons difficult. The Scoliosis Research Society recently introduced new standardized inclusion and assessment criteria for future brace studies. ⋯ The assessment criteria include: percentage of patients with < or = 5 degree curve progression and percentage of patients with > or = 6 degree curve progression at skeletal maturity, percentage of patients who had surgery or recommended before skeletal maturity, percentage of patients with curves exceeding 45 degrees at maturity, and a minimum of 2 years follow-up beyond skeletal maturity for those patients felt to have been successfully treated. All patients treated irregardless of compliance are to be included in the results (intent to treat). The use of these criteria should assist in the determination of the effectiveness of brace treatment, as well as accurate comparison between patient groups and different braces.
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Spinal curvatures alter measured stature and may influence the evaluation of skeletal maturity and growth based on stature measurements. ⋯ The findings of the present study indicate that height loss (in mm) occurring with a 10 degrees increase in mean Cobb angle (for two curves) would be 1.1+0.16 times the mean Cobb angle (in degrees). For example, for a Cobb angle change from 30 to 40 degrees, the expected height loss would be 1.1+35*0.16 mm=6.7 mm. This assumes that height loss occurs only as a result of altered curvature, without alteration in disc height associated with an increase in scoliosis.
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Stud Health Technol Inform · Jan 2008
Risser sign: the value of the lateral spinal radiograph to assess the excursion of the iliac apophysis.
The course of the ossification of the iliac apophysis is considered in adolescent patients with idiopathic scoliosis, under the name of the Risser sign, to determine the remaining spinal growth. Although the iliac crest develops in the three-dimensional space as a complex structure, the iliac apophysis ossification has been assessed only on a one plane frontal spinal radiograph. This study points out the usefulness of the lateral radiograph for the visualization of the whole iliac crest, especially the posterior region which otherwise cannot be observed. ⋯ The regions of the maximal thickness corresponded to the earliest appearance of the apophysis ossification (Risser 1), while the thin part of the iliac bone corresponded to late appearance of the apophysis ossification (Risser 3-4). The ossification of the posterior part of the crest was best visualized with the lateral radiograph, which was exclusive in showing the posterior superior iliac spine region. On the frontal spinal radiograph the end of the course of the apophysis (Risser 3-4) is usually searched at the level of the sacroiliac joint, while in reality this point was found to be situated more caudal, and accessible for observation on the lateral radiograph.
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Stud Health Technol Inform · Jan 2008
Open source electronic health record and patient data management system for intensive care.
In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed a PDMS and EHR based on open source software and components. ⋯ The developed system based on open source software components was able to respond to the medical needs of the local ICU environment. The use of OSS for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system.
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What started in Berlin in May of 2000 as an idea to create the telemedicine program of Kosova in order to help the country rebuild the broken medical system and change the miserable face of medicine, has now spread to other countries in the Balkans. Today, June 29, 2007, as I am rewriting this chapter, ten doctors and engineers from Kosova, Montenegro and Macedonia graduated from a three weeks intensive course on telemedicine, e-health and medical electronic library. This international telemedicine fellowship is organized by the very entity that was created in Berlin 7 years ago: The International Virtual e-Hospital (IVEH). ⋯ Soon we will be traveling to Atalaya, Peru and other communities of Amazon River, then Africa. We will not stop. One country at a time!