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  • 1
    In: Journal of Telemedicine and Telecare, SAGE Publications, Vol. 25, No. 7 ( 2019-08), p. 414-424
    Abstract: Tele-monitoring (TM) has proved effective in the home management of adult ventilator-dependent neuromuscular disease (NMD) patients. We aimed to evaluate a 2-year longitudinal multicentre TM trial designed for young ventilated NMD patients in terms of feasibility, home management of exacerbations and caregivers’ burden. Methods The TM trial protocol included patients’ weekly scheduled overnight home-recording of SpO 2 , heart rate and ventilation and their transmission to each TM centre the following morning. Overnight data were reviewed by non-physicians and calls to families made to assess clinical condition. If clinical conditions (assessed by a scoring system) or overnight parameters worsened, either unscheduled transmissions or calls were activated and managed by non-physicians or medical team according to severity. Hospitalisations were compared with those of TM patients prior to TM start and with those of age-disease-severity-matched controls. Scores from the Caregiver Burden Inventory (CBI) questionnaire pre- and post-TM were compared. Results Forty-eight patients were enrolled, 30 males, median age 16.4 years (interquartile range (IQR) 8.9–22.1), median ventilation/day 10.5 h (IQR 8–16). Exacerbations in TM patients did not differ (59 versus 53; p = 0.15) from controls. Hospitalisations were significantly reduced in TM patients when compared with those prior to TM (11 versus 24, p = 0.04) and to controls (11 versus 21, p = 0.03). Median hospitalisation length was significantly lower in TM patients than controls (6 versus 7 days, p = 0.03 ). Caregivers satisfaction was excellent whereas no significant changes in CBI were seen (32.5 versus 35.5, p = 0.06). Discussion TM was effective in improving the home management of respiratory exacerbations in young ventilated NMD patients and overall well tolerated.
    Type of Medium: Online Resource
    ISSN: 1357-633X , 1758-1109
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2007700-2
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 2002
    In:  Tumori Journal Vol. 88, No. 4 ( 2002-07), p. 284-287
    In: Tumori Journal, SAGE Publications, Vol. 88, No. 4 ( 2002-07), p. 284-287
    Abstract: Krukenberg tumors are ovarian metastases from a gastroenteric malignancy in 90% of cases. At present, diagnostic imaging techniques (US, CT, MRI) do not provide any reliable diagnostic criteria to differentiate these metastases from ovarian primaries. We tried to use multivariate analysis to distinguish malignant ovarian primaries from Krukenberg tumors based on their differential natural history. Patients and Methods We retrospectively compared the CT findings of Krukenberg tumors (47 patients, 79 masses, only from gastroenteric malignancy) with CT findings of primary epithelial ovarian cancers (46 patients, 67 masses). We compared the same independent variables in the two groups: age, morphology, margins, carcinomatosis, bilateral versus unilateral involvement, ascites, lymph node involvement, metastases on the basis of multivariate analysis. Results According to the best fitted model, clear-cut margins (OR: 3.75; 95% Cl: 1.14-9.72) and the presence of carcinomatosis (OR: 4.21; 95% Cl: 1.51-11.72) were the strongest predictors of a diagnosis of Krukenberg tumor. In contrast, the presence of ascites was more likely to be a protective factor (OR: 0.22; 95% Cl: 0.08-0.62). Conclusions We can try to make a differential diagnosis between a metastatic lesion from the gastroenteric tract and a primary adnexal lesion based on the multivariate statistical analysis of intraperitoneal spread of the different types of cancer rather than on morphologic findings at CT.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2002
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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