Journal of Advanced Health Care最新文献

{"title":"Advanced neuroimaging techniques in the clinical routine: A comprehensive MRI case study","authors":"V. Alfano, Gianluca Granato, Antonello Mascolo, Salvatore Tortora, Luca Basso, Antonio Farriciello, Paolo Coppola, Michele Manfredonia, Fabrizio Toro, Alfredo Tarallo, Giovanni Moggio","doi":"10.36017/jahc202462336","DOIUrl":"https://doi.org/10.36017/jahc202462336","url":null,"abstract":"Neuroimaging with Magnetic Resonance Imaging (MRI) is one of the most useful tools available to study the human brain in vivo. Several techniques provide insights into the human brain's structure, function, and connectivity. The aim of this study is to showcase the feasibility of employing advanced neuroimaging techniques within the clinical routine in a patient with a neurological disorder. An 83 years-old male patient with right motor aphasia and somatosensory impairment underwent a clinical and advanced neuroimaging MRI protocol with 3D-T1, FLAIR, diffusion-weighted and tensor imaging, and resting state functional MRI. Advanced neuroimaging post-processing was employed to perform cortical and subcortical brain segmentation, white matter fibers tractography, and functional connectivity (FC). These analyses revealed an impairment of the left posterior insular cortex that showed low cortical grey matter volume, high restriction in diffusivity maps, and an increased FC as a compensation mechanism. The results pointed towards a left insular cortex stroke and the patient was then admitted to neurology for hospitalization. This amalgamation of cutting-edge technology with clinical practice underscores the pivotal role of neuroimaging in the contemporary management of neurological disorders, heralding a new era of precision medicine tailored to individual patient profiles.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"114 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140680536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The revolution of photon-counting CT towards new horizons of diagnostic imaging","authors":"Emma Scarfato, Stefania Stile, Vincenzo Maiello, Giuseppe De Feo","doi":"10.36017/jahc202462333","DOIUrl":"https://doi.org/10.36017/jahc202462333","url":null,"abstract":"Photon-counting Computed Tomography (PCCT) is a new computed tomography detection technology that uses photon-counting detectors to convert individual X-ray photons directly into an electrical signal and has the potential to overcome limitations of previous CT systems, such as limited spatial resolution, or lack of spectral information. The upcoming development in PCCT technology promises to enhance image resolution, contrast, and diagnostic accuracy while reducing radiation doses to patients. In this review article, we aim to evaluate the basic principles and potential clinical benefits of PCCT, with particular attention to the constantly evolving recent literature and the changes that this method will meticulously bring to the world of cardiovascular and neuroradiological diagnostic imaging.\u0000 ","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":" 58","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140683313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacoeconomics and wound care. When therapeutic appropiateness and cost savings move in the same direction","authors":"I. Filoso, Ivana Citro, M. R. Iacolare, Ida Monti, Nunzio Quinto, Giacomo Russo, Attilio Tortora, Lucio Marcello Falconio","doi":"10.36017/jahc202462311","DOIUrl":"https://doi.org/10.36017/jahc202462311","url":null,"abstract":"In the year 2019, 121 patients were admitted to the Casavatore Hospice. All patients, upon admission, exhibited pressure ulcers (Ldp) in both stages I and II. A portion of the patients with stage II ulcers were treated with advanced dressings containing micronized silver (20 patients), resulting in a regression of the ulcer to stage I. Subsequently, they were treated with topical application of silver sulfadiazine cream until complete healing of the lesion. Patients who did not have favorable indications for the application of such treatment were treated with Sofargen cream (60 patients), nonetheless preventing the worsening of the stage of the pressure ulcer. Patients with stage I ulcers (41 patients) were treated daily with silver sulfadiazine spray, which still contributed to the prevention of secondary lesions associated with immobility. \u0000The objective of managing pressure ulcers in bedridden or terminal patients has been fully achieved within dignified care times and, above all, with reduced company costs. \u0000As a final result, considering the current prices for both dressings and the specific drug, we achieved an economic savings exceeding 35%, highlighting how it is possible to implement, in various aspects and situations, important yet simple care approaches while respecting therapeutic appropriateness and patient compliance.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140688551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Clinical Risk Awareness in Speech Therapy Practice","authors":"Alberto Bua, Luigi Umberto Collovà, Girolamo Verlanti","doi":"10.36017/jahc202462335","DOIUrl":"https://doi.org/10.36017/jahc202462335","url":null,"abstract":"Introduction: Clinical risk management in healthcare is the set of actions to improve the quality of care and ensure patient safety. In recent years, Italy has made progress in patient safety with the sentinel event reporting system, education and training, stakeholder engagement, and examination of legal and insurance issues. Error is unavoidable but should be considered as a \"source of knowledge and improvement\" to prevent repetition and ensure the safety of healthcare. However, there is no \"zero risk\" health care area and studies on risk management in rehabilitation are rare.Methods: This study aims to analyze the presence of clinical risk in speech therapy, identifying the most common errors and possible causes. The research was conducted with a cross-sectional statistical survey, using questionnaires administered to speech therapists operating in three Italian regions (Veneto, Campania and Sicily). The study participants were both employed and self-employed speech therapists who worked in public, private, and contracted facilities.The questionnaire consisted of two sections: the first collected demographic information about the participants, while the second focused on awareness of clinical risks and the frequency of specific errors. Respondents were asked questions about their knowledge of clinical risk in speech therapy, the frequency with which certain errors occur, and other errors they felt were important to report.The survey results were collected and analyzed using Microsoft Access software and the results were analyzed to measure outcomes. The study sample consisted of 234 speech therapists.Results: The results of the data analysis collected through Microsoft Access showed that most of the respondents (between 33% and 72%) often encountered errors in their clinical practice in various areas such as clinical evaluation of the patient's main problem, outcome measurement error, speech therapy argumentation, therapy, use of aids, respect for the patient, hygienic-sanitary standards, etc.Conclusions: The study identified common errors in the clinical practice of speech therapists, including evaluation, treatment planning, and use of aids. These errors are important for the quality of care provided to patients and should be avoided through continuous education and evidence-based clinical practices. The research provides valuable information for the speech therapy community and future research should investigate the factors contributing to training gaps in clinical risk.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"26 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The patient positioning in the MR of the shoulder: advantages and disadvantages of the internal, external and neutral rotation of the arm","authors":"Calogero Curatolo, Maria Chiara Amato","doi":"10.36017/jahc202462318","DOIUrl":"https://doi.org/10.36017/jahc202462318","url":null,"abstract":"Tailoring the patient positioning in Magnetic Resonance Imaging, according to patient needs and clinical questions, is the key to successfully completing a highly diagnostic exam. This is evident in the MRI study of the shoulder in which, for clinical questions such as subacromial conflict syndrome and suspected lesions of the Rotator Cuff, is essential to obtain an accurate distension of the tendons, in order to make reporting free from doubtful or improper diagnoses. The possible arm placements for this kind of examination are: intra-rotation, extra-rotation, or neutral position. Each of them presents advantages and disadvantages that the MR radiographer must be able to assess in conjunction with the patient's conditions and the degree of cooperation. Intra-rotation is clearly the position that ensures greater comfort and stability to the patient and this results in the absence of artifacts from movement, but on the other hand it does not allow the distension of the supraspinatus tendon and the long head of the brachial biceps, it causes the overlap of supraspinatus tendon with infraspinatus one in the oblique coronal sequences, thus leading to misdiagnosis or dubious diagnosis. The arm’s neutral position is ideal for moderately collaborating patients and promotes a mild relaxation of the tendons and the absence of movement artifacts. Finally, the arm’s position in extra-rotation, obtained with variable positioning of pads under the forearm, ensures the collaboration of a substantial number of patients and tendons are well stretched and free from overlap, addressing reliable diagnoses, despite having, as the only disadvantage, a possible lower degree of cooperation of the patient.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"244 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Bone Scintigraphy in The Diagnosis of Cardiac Amyloidosis","authors":"Francesca Elia, Gaetano Ungaro, Carmine Pecoraro, Kevin Amoruso, Antonio Di Lascio, Riccardo Paglialunga, Gabriella Fiorillo","doi":"10.36017/jahc202462231","DOIUrl":"https://doi.org/10.36017/jahc202462231","url":null,"abstract":"Cardiac amyloidosis is a rare and progressive condition caused by the buildup of amyloid in the heart. There are two common forms of cardiac amyloidosis: light-chain amyloidosis (AL) and transthyretin amyloidosis (ATTR). The deposition of amyloid in the extracellular matrix of the myocardium leads to heart failure over time, and if left untreated, it can even be fatal. For this reason, early diagnosis is essential for both prognosis and improving patients' quality of life. Since cardiac amyloidosis is a potentially treatable condition, early diagnosis is key to improving patient survival and quality of life. There is now compelling evidence showing that nuclear imaging plays a fundamental role in the non-invasive diagnosis of transthyretin cardiac amyloidosis. Due to its high sensitivity and specificity, radiotracer compounds that target the bones are considered sufficient for establishing the diagnosis, avoiding the need for endomyocardial biopsy. In this study, we analyzed data obtained from examinations conducted on patients referred to the Cardiology Department of the \"San Giovanni di Dio e Ruggi d'Aragona\" University Hospital, who presented with suspected cardiac amyloidosis. These patients underwent scintigraphy with 99mTc-HMDP (hydroxymethylenediphosphonate), using a large-field computerized gamma camera with a parallel-hole collimator and SPECT. After performing early whole-body planar acquisitions at 5 minutes and late acquisitions at 3 hours after intravenous administration of approximately 700 MBq of Tc-99m HMDP, myocardial uptake was observed. Subsequently, targeted acquisitions and SPECT tomographic studies were performed on the myocardial uptake areas. All acquired images were subsequently subjected to quantitative and qualitative analysis, allowing us to extract a large number of parameters reflecting morphological and predictive characteristics using radiomics and more or less automated analysis algorithms. This analysis enabled us to obtain quantitative information that is not apparent in a qualitative image analysis. The ability to extract hidden information from digital medical images is of particular interest as it can enhance the predictive capabilities of existing automatic segmentation algorithms. Extracting new information that was previously hidden can be utilized for automatic image segmentation.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"21 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech therapy screening project in the islands of Lampedusa, Linosa and Ustica","authors":"Federico La Tona, Alberto Bua","doi":"10.36017/jahc202461317","DOIUrl":"https://doi.org/10.36017/jahc202461317","url":null,"abstract":"In the general population of 5-year-old children, those with Specific Language Disorders represent about 7%. The difficulties, which are more evident in the first years of life, often continue into school age, for this reason, it is of crucial importance to promptly intercept these health needs to guarantee the management and resolution of linguistic difficulties which, if not treated, will transition to the area of school learning. This work aims to identify children at risk concerning language development. The screening program involved all classes of nursery school and the first and second year of primary school, evaluating possible linguistic problems in the 6-8 age group. The speech therapy screening involved the administration of the Articulation Test. From the analysis of the data, it emerged that 12% of the participants, i.e. 21 children (11 children resident in the municipality of Lampedusa and Linosa, 10 children resident in the municipality of Ustica) were identified as at risk for language delay. For children identified at risk, an in-depth clinical-diagnostic investigation was requested. From this experience of prevention and awareness at an early age for language disorders, the importance of identifying risky situations early on is evident to support the correct evolution of verbal production and avoid that a late intervention could make the most serious situation. Nursery school represents a crucial place and moment for recognizing a possible difficulty. Unfortunately, attention to children's language is not yet optimal and is often directed only to those cases that show obvious signs of delay. This is why early identification of difficulties and timely management by the speech therapist is so important.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the adoption of an artificial intelligence algorithm for the automatic segmentation of visceral organs.","authors":"Alberto Mastrodonato, Maria Urbano","doi":"10.36017/jahc202461282","DOIUrl":"https://doi.org/10.36017/jahc202461282","url":null,"abstract":"The study aimed to automate CT organ segmentation using image processing and machine learning. The process involved data acquisition, labeling, neural network training, validation, testing, segmentation, analysis, interpretation, feedback, improvement, documentation, and sharing. Analyzing 20 anonymized patients on two high-performance workstations, segmenting thoraco-abdominal regions, liver, and spleen using 3D SLICER and plugins. Repeatability tests using \"Autodesk Meshmixer\" and \"Prusa Slicer\" revealed workstation 2 took nearly three times longer in 'fast' mode and 13 times longer in 'normal' mode compared to workstation 1. In conclusion, the study explored AI for organ segmentation, showing efficiency and potential cost reduction. Legal, ethical, and technical challenges include privacy concerns, professional responsibility, and the need for annotated data. Interoperability, adaptability, staff training, and continuous monitoring are crucial for AI effectiveness and safety in clinical settings. Despite challenges, AI proves valuable for precise, timely medicine, supporting medical personnel.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"46 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140267618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise reconditioning in the post-acute phase of COVID-19 rehabilitation in patients with chronic respiratory insufficiency: a retrospective observational study","authors":"Mariapina Rasi, Francesca Rubino, Gianluca Battaglia, Carmela Bonomo, Concetta Sorce, Giuseppe Enea","doi":"10.36017/jahc202461273","DOIUrl":"https://doi.org/10.36017/jahc202461273","url":null,"abstract":"INTRODUCTION: The COVID-19 pandemic has had a profound impact on a global scale, affecting various aspects of society, health, and well-being. It has strained healthcare systems and led to social and welfare repercussions. In the context of post-acute COVID-19 rehabilitation, there is a need to explore effective interventions for individuals, particularly those with chronic respiratory insufficiency. This study aims to evaluate the effectiveness of exercise reconditioning as a rehabilitation strategy in this specific population\u0000METHODS: A retrospective observational study was conducted at the Rehabilitation Unit in an Italian hospital between March 2020 and May 2022. The study included individuals who had been diagnosed with COVID-19 pneumonia, required hospitalization in the COVID-19 unit or intensive care unit (ICU) due to severe respiratory failure and with “post-COVID pathology syndrome” (PCS) picture. Various assessments, including the 6 Minutes Walking Test (6MWT), were conducted to determine exercise capacity. A personalized reconditioning program based on international guidelines was designed for each patient, focusing on aerobic training. Measurements of vital signs were taken during training sessions.\u0000RESULTS: A total of 24 individuals, with a mean age of 65.41 years, were included in the study. The average duration of hospitalization in the rehabilitation department was 53.17 days. Most participants had pre-existing respiratory and non-respiratory pathologies. All individuals developed COVID-19 interstitial pneumonia, and some required intensive interventions such as intubation or ECMO support. Pulmonary fibrosis and Critical Illness Myopathy (CIM) were observed in a significant portion of the participants. Significant improvements were observed in the 6MWT distance traveled, Functional Independence Measure (FIM) scale score, fraction of inhaled oxygen (FiO2), and dyspnea scores. Perceived exerction measures also showed positive changes.\u0000DISCUSSION AND CONCLUSION: The findings of this study indicate that personalized reconditioning plan is effective in improving the functional capacity and overall condition and quality of life of individuals with post-COVID pathology syndrome. These findings highlight the importance of an interdisciplinary approach and tailored rehabilitation programs in this population. Further research is needed to explore the long-term effects of exercise reconditioning in this population.\u0000 ","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140445013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation and conservative treatment of shoulder instability in volleyball players an overview","authors":"Luca Collebrusco, Valentina Tanoni","doi":"10.36017/jahc2024612","DOIUrl":"https://doi.org/10.36017/jahc2024612","url":null,"abstract":"Background: Currently the conservative approach regarding shoulder instability in volleyball player results still be highly contested and discussed in clinical practice. To stipulate a rehabilitation treatment appropriate and personalized, it will be crucial to include the local region in the preliminary assessment compromised and the global kinetic chain, given the numerous correlations between the different body districts.\u0000Objective: Evaluate through the collection of literature the best scientific evidence regarding the evaluation and conservative treatment of shoulder instability in volleyball player to be used as an option in situations where surgical treatment would be excessive and invasive for the young athlete.\u0000Method: The research was conducted by a single operator through a review of the literature of the last 15 years in databases such as Medline, PubMed and Pedro. The research began in January 2022 and ended in March 2022. The selection of the articles was made on the basis of the reading of the title, abstract and full-text.\u0000Result: The research initially yielded 66 scientific articles but after reading the title, abstract and full-text, 19 related articles were considered. The best evidence has been sought regarding treatment protocols for shoulder instability in the athlete.\u0000Conclusion: According to the researches carried out the recommendations of the authors and the results obtained by the latter, the conservative approach plays a fundamental role in the recovery in case of shoulder instability. Most athletes have felt positive not only physically but also mentally. Despite this, more extensive studies will be needed in the future, to ensure the professional and the athlete a protocol of conservative recovery as appropriate as possible.","PeriodicalId":14873,"journal":{"name":"Journal of Advanced Health Care","volume":"234 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140459787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}