Academic literature on the topic 'Carelink 2090'

The abstract: the paper presents the urgency of the problem of integrating of medical information systems and external specialized software products. The main goal of the paper is to optimize the process of remote monitoring of the patient’s health with an implanted device. As a result, the integration module of the hospital information system of the Federal state budget foundation “Federal center of cardiovascular surgery” of the Ministry of Health of the Russian Federation (Astrakhan) was introduced, in terms of the patient’s Electronic Health Records (EHR) and Medtronic CareLink remote monitoring system. The ability to integrate various medical systems makes it possible to optimize the processing of electronic medical documents, in particular, routine data collection and processing operations in the patient’s electronic medical record (Electronic Health Records, EHR) in the daily work of a medical specialist.

Telemonitoring of implantable devices is a long known and established element of heart failure patients’ care. All companies that produce implantable devices also deliver remote monitoring systems. Clinical data show safety and efficacy in this kind of care. It prevents hospitalisations due heart failure exacerbations. It also allows to reduce costs of care by reducing the number of in office visits and transport costs. In COVID-19 pandemy time cardiologic associacions (including polish) recommend using remote monitoring systems to reduce the spreading of pandemy and the risk of infection in heart failure patients. Until now there was no possibility in the polish healthcare system to reimburse remote care. After Polish Health Ministry announcement this possibility appears for the first time. The Implantable Device Ambulance of Western Hospital in Grodzisk Mazowiecki has 88 patients with implanted ICDs and CRTDs under remote care. System Carelinc of Medtronic allowed the number of relevant clinical decisions. From March 2020 the patients in the telemonitoring group undergo remote visits which are reimbursed by the National Health Fund.

Objective. To evaluate whether pelvic measurements have any association with operative vaginal deliveries and the duration of the second stage of the delivery. Study design. A retrospective study of pregnant women at an increased risk of fetal-pelvic disproportion during 2000–2008 in North-Carelian Central Hospital. The mode of the vaginal delivery was chosen to represent the reference standard. The target condition was spontaneous vaginal delivery. Patients were divided into subgroups according to the size of the fetus and also by the parity to evaluate the variability reflecting differences in patient groups. Receiver operating characteristic (ROC) curves were established. Results. A total of 226 participants with fetal cephalic presentation delivered vaginally; of these, 184 women delivered spontaneously, and 42 women required operative vaginal delivery with vacuum extraction. There were no clinically or statistically significant differences between the size of the maternal pelvic outlet and the different modes of delivery types within these subgroups. With respect to the pelvic inlet and outlet, the areas under the curve in ROC were 0.566 with the P value of 0.18 and 95% confidence interval (CI) of 0.465–0.667 and 0.573 (95% CI: 0.484–0.622; P=0.14). Conclusions. The maternal bony pelvic dimensions exhibited virtually no correlation with the need for operative vaginal deliveries.

The article reports on the application of the best known principles for mapping natural populations of curly (Karelian) birch Betula pendula Roth var. carelica (Mercklin) Hämet-Ahti – one of the most appealing representatives of the forest tree flora. Relying on the synthesis and analysis of the published data amassed over nearly 100 years and the data from own full-scale studies done in the past few decades almost throughout the area where curly birch has grown naturally, it is concluded that its range outlined in the middle of the 20th century and since then hardly revised is outdated. The key factors and reasons necessitating its revision are specified. Herewith it is suggested that the range is delineated using the population approach, and the key element will be the critical population size below which the population is no longer viable in the long term. This approach implies that the boundaries of the taxon range depend on the boundaries of local populations (rather than the locations of individual trees or small clumps of trees), the size of which should not be lower than the critical value, which is supposed to be around 100–500 trees for curly birch. A schematic map of the curly birch range delineated using this approach is provided. We specially address the problem of determining the minimum population size to secure genetic diversity maintenance. The advantages of the population approach to delineating the distribution range of curly birch with regard to its biological features are highlighted. The authors argue that it enables a more accurate delineation of the range; shows the natural evolutionary history of the taxon (although it is not yet officially recognized as a species) and its range; can be relatively easily updated (e.g. depending on the scope of reintroduction); should be taken into account when working on the strategy of conservation and other actions designed to maintain and regenerate this unique representative of the forest tree flora.

Background:Patients affected by chronic inflammatory diseases of the skin or joints (CIDs; including psoriasis [PSO], rheumatoid arthritis [RA], juvenile idiopathic arthritis [JIA], psoriatic arthritis [PsA], non-radiographic axial spondyloarthritis [nr-axSpA; reported in the survey as ‘axSpA’], or ankylosing spondylitis [AS]) may be challenged in their attempts to have children. A multinational survey conducted in Europe and the US, including 969 patients, revealed that most patients’ concerns regarding family planning and pregnancy (FPP) were inadequately or inconsistently addressed.1Objectives:To investigate the general level of information on FPP and the potential concerns among Danish patients with CIDs.Methods:An online survey to identify FPP issues was designed, and CID patients aged 18–50 years (yrs) were included. Respondents were recruited through patient organisations providing their members with a link to the questionnaire. In addition to demographics, information relating to time of diagnosis, treatments received, pregnancies, and course of disease were collected along with access to and concerns regarding FPP. Descriptive statistics were applied.Results:Eligible patients included 368 with rheumatological diagnoses (RA, PsA, JIA, nr-axSpA, or AS; 304 [83%] female, mean age: 40 yrs; 64 [17%] male, mean age: 42 yrs) and 95 with dermatological diagnoses (PSO or PsA; 64 [67%] female, mean age: 37 yrs; 31 [33%] male, mean age: 42 yrs). Among the rheumatic patients, 43% of females and 53% of males were currently receiving systemic treatment and 37% of females and 22% of males had received >3 different systemic treatments (other than painkillers and non-steroidal anti-inflammatory drugs [NSAIDs]). Lack of access to FPP information was consistent across age groups, but higher in those with dermatological diagnoses (Table).In total, 68% of patients with rheumatological and 73% with dermatological diagnoses had biological children and among these 18% and 23% of patients, respectively, indicated their disease had affected how many children they had or planned to have. The most frequent concerns among patients with rheumatological diagnoses were the potential physical impact of a pregnancy, disease worsening, heredity and being able to take care of the child (19, 16, 16 and 13%, respectively), whilst disease worsening and heredity (12 and 16%, respectively) were the most frequent concerns in those with dermatological diagnoses. Many patients experienced disease worsening during or after pregnancy (rheumatologic diagnoses: 16% and 34%; dermatologic: 20% and 59%, respectively).Conclusion:Danish CID patients of reproductive age have concerns related both to their disease and to FPP, which affect their decisions around family planning. The majority of patients responding to this survey reported limited access to information about FPP, pointing to a need for healthcare professionals to provide standardised family planning information.References:[1] Chakravarty E. BMJ Open 2014;4:e004081.Table.Thematic analysis and quotesThemeDescriptionQuoteOral-RA linksRA medications caused dry mouthThe medications, really, really are awful on your mouth, in particular prednisone. I get very raw gums… it [was] painful to brush my teeth.We don’t have saliva to wash things away. We have a different mouth floraComplicated oral careTime-demanding oral care routines.Multiple oral health care tools and adaptations used depending on current oral health, and RA activity.The severe pain made it very hard to open my mouth to brush my teeth. The joint damage [makes it] really hard to handle a toothbrush.We have to have toothbrushes with a wide handle… and different attachments when we need them.Even with those [special] products, the pain sometimes was just overwhelming. I’m dedicated about brushing my teeth, but boy, it was a struggle. It took me a long time to brush my teeth.Access to professional oral careLack of dental insurance and costs of careLogistical access: multiple dental visits.Physical access: attending appointments; prolonged sitting in a dental chair.I have a hygienist, and a dentist, and a gum dentist and a bunch of dentists with fancy names. I see them every 3 months.Dental offices have dental hygienists. And some of them are an A+, and some of them are C-…it’s important that hygienists are trained, that they really understand the tools.When I go back in the [dental] chair, it was uncomfortable [when first diagnosed]. I struggled. I couldn’t keep my mouth open.Shame due to oral healthShame relating to poor oral health.Seeking oral care possibly considered unusual for their age.I would feel ashamed. Something’s wrong. Everyone around me has these beautiful teeth. I don’t, and something is wrong.I’m getting braces. At my age, I’m getting braces.Table.Proportion of patients with rheumatological or dermatological diagnoses who reported having little or no access to FPP information, stratified by ageAgeRheumatological diagnosisN (%)Dermatological diagnosisN (%)18–29 yrs19 (49)14 (74)30–39 yrs61 (58)16 (73)40–50 yrs134 (60)34 (63)Acknowledgments:This study was funded by UCB Pharma. Editorial services were provided by Costello Medical.Disclosure of Interests:Karen Schreiber Consultant of: UCB Pharma (Advisory Board), Caecilie Johansen Consultant of: UCB Pharma (Advisory Board), Ulla-Fie Jensen Consultant of: UCB Pharma (Advisory Board), Employee of: UCB Pharma, Alexander Egeberg Grant/research support from: Pfizer, Eli Lilly, Novartis, AbbVie, Janssen Pharmaceuticals, the Danish National Psoriasis Foundation and the Kgl Hofbundtmager Aage Bang Foundation, Consultant of: UCB Pharma (Advisory Board), Speakers bureau: AbbVie, Almirall, Leo Pharma, Samsung Bioepis Co. Ltd., Pfizer, Eli Lilly, Novartis, Galderma, Dermavant, UCB Pharma, Mylan, Bristol-Myers Squibb and Janssen Pharmaceuticals, Simon F. Thomsen Grant/research support from: UCB Pharma, AbbVie, Novartis, Sanofi, Leo Pharma, and Janssen Pharmaceuticals, Consultant of: UCB Pharma (Advisory Board), AbbVie, Novartis, Sanofi, Eli Lilly, Roche, Janssen Pharmaceuticals, Pfizer, Celgene, Leo Pharma, Almirall, Speakers bureau: UCB Pharma, AbbVie, Novartis, Sanofi, Eli Lilly and Leo Pharma, Asbjorn L Hansen Consultant of: UCB Pharma (Advisory Board), Employee of: UCB Pharma, Trine Bay Laurberg Consultant of: UCB Pharma (Advisory Board), Lone Skov Grant/research support from: Pfizer, AbbVie, Novartis, Sanofi, Janssen Pharmaceuticals, and LEO Pharma, Consultant of: UCB Pharma (Advisory Board), AbbVie, Janssen Pharmaceuticals, Novartis, Eli Lilly, LEO Pharma, Almirall, and Sanofi, Speakers bureau: AbbVie, Eli Lilly, Novartis, and LEO Pharma. Investigator for AbbVie, Janssen Pharmaceuticals, Boehringer Ingelheim, AstraZeneca, Eli Lilly, Novartis, Regeneron, and LEO Pharma, Lars Erik Kristensen Consultant of: UCB Pharma (Advisory Board), Sannofi (Advisory Board), Abbvie (Advisory Board), Biogen (Advisory Board), Speakers bureau: AbbVie, Amgen, Biogen, Bristol-Myers Squibb,Celgene, Eli Lilly, Gilead, Forward Pharma, Janssen Pharmaceuticals, MSD, Novartis, Pfizer, and UCB Pharma

Background COVID‐19 was temporally associated with an increase in out‐of‐hospital cardiac arrests, but the underlying mechanisms are unclear. We sought to determine if patients with implantable defibrillators residing in areas with high COVID‐19 activity experienced an increase in defibrillator shocks during the COVID‐19 outbreak. Methods and Results Using the Medtronic (Mounds View, MN) Carelink database from 2019 and 2020, we retrospectively determined the incidence of implantable defibrillator shock episodes among patients residing in New York City, New Orleans, LA, and Boston, MA. A total of 14 665 patients with a Medtronic implantable defibrillator (age, 66±13 years; and 72% men) were included in the analysis. Comparing analysis time periods coinciding with the COVID‐19 outbreak in 2020 with the same periods in 2019, we observed a larger mean rate of defibrillator shock episodes per 1000 patients in New York City (17.8 versus 11.7, respectively), New Orleans (26.4 versus 13.5, respectively), and Boston (30.9 versus 20.6, respectively) during the COVID‐19 surge. Age‐ and sex‐adjusted hurdle model showed that the Poisson distribution rate of defibrillator shocks for patients with ≥1 shock was 3.11 times larger (95% CI, 1.08–8.99; P =0.036) in New York City, 3.74 times larger (95% CI, 0.88–15.89; P =0.074) in New Orleans, and 1.97 times larger (95% CI, 0.69–5.61; P =0.202) in Boston in 2020 versus 2019. However, the binomial odds of any given patient having a shock episode was not different in 2020 versus 2019. Conclusions Defibrillator shock episodes increased during the higher COVID‐19 activity in New York City, New Orleans, and Boston. These observations may provide insights into COVID‐19–related increase in cardiac arrests.

In questa tesi viene descritta l'evoluzione dei pacemaker, dal primo introdotto nel 1958 fino ai giorni nostri con l'arrivo di tecnologie sempre più efficienti e miniaturizzate. In particolar modo per chi soffre di bradicardia è stato introdotto in commercio dal 2015 il pacemaker più piccolo al mondo: il Micra TPS (Transcatheter Pacing System). Questo pacemaker monocamerale viene inserito nel ventricolo destro del paziente attraverso un sistema di ancoraggio, permettendo una miglior praticità per il paziente rispetto al classico pacemaker "scatola e filo". I vantaggi principali di questo pacemaker sono: dimensioni,durata batteria,materiali e compatibilità con applicazioni per smartphone e tablet.